Anophthalmic socket in retinoblastoma: Exploring complications and risk factors in a tertiary centre in Malaysia

Ng, Lay Hui and Chang, Li Yen and Mohamad, Nor Fadhilah and Rahmat, Jamalia (2024) Anophthalmic socket in retinoblastoma: Exploring complications and risk factors in a tertiary centre in Malaysia. European Journal of Ophthalmology, 34 (4). pp. 999-1008. ISSN 1120-6721, DOI https://doi.org/10.1177/11206721231219530.

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Official URL: https://doi.org/10.1177/11206721231219530

Abstract

Purpose: To evaluate the complications of anophthalmic socket in retinoblastoma patients at a tertiary centre in Malaysia. Design: Retrospective study Methods: Patients who underwent enucleation for retinoblastoma were reviewed from 2004-2020. Details were recorded, including demographics, diagnosis, surgical techniques, implant types, additional therapies, and complications. Results: Of 250 patients with retinoblastoma managed over the period, the anophthalmic sockets of 160 eyes who underwent enucleation were analysed. The mean age at enucleation was 2.03 years (26 days to 9.18 years). The follow-up periods after enucleation range from 5 days to 16.83 years. Porous polyethylene (Medpor) implants were used in 135 patients (84.4%), as were Bioceramic in 9, glass balls in 7, acrylic in 7, dermis fat grafts in 1, and silicone implants (Aurosphere) in 1. The overall complications in our study were 28.8%. Complications seen in the study included implant exposure (12.5%), shallow inferior fornix (10.6%), granuloma formation (3.1%), discharge (2.5%), implant migration (1.9%), ptosis (0.6%), and orbital dystopia (0.6%). Implant exposure is solely found in Medpor, more common in those with donor sclera caps, and exposure times range from 28 days to 11.42 years. The suturing of the Tenon and conjunctiva in separate layers significantly reduced the rate of implant exposure. Six out of seven radiation patients had shallow inferior fornixes. Conclusions: Long-term post-enucleation complications were not uncommon. Luckily, most had good outcomes, with a few needing surgical intervention. Meticulous suturing technique on the Tenon and conjunctival layer is essential to prevent implant exposure.

Item Type: Article
Funders: UNSPECIFIED
Uncontrolled Keywords: Retinoblastoma; enucleation; anophthalmic socket; implant exposure
Subjects: R Medicine > RE Ophthalmology
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 09 Dec 2024 06:33
Last Modified: 09 Dec 2024 06:33
URI: http://eprints.um.edu.my/id/eprint/47137

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