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Pediatric Enucleation
Analysis of Volume Replacement
Sara A. Kaltreider, MD;
Lilian R. Peake, MD, MPH;
Bruce T. Carter, MD
Arch Ophthalmol. 2001;119:379-384.
Objectives To determine the percent volume replacement by an implant and prosthesis,
the long-term sequelae of poor volume replacement, and specific guidelines
for volume replacement in pediatric patients.
Methods A retrospective observational study of 16 pediatric patients who underwent
enucleation (group 1) and 31 adult patients enucleated in childhood (group
2) was performed. The total volume replacement and the volume replacement
by the implant were determined. The incidence of secondary surgical procedures
for superior sulcus deformity, enophthalmos, ptosis, ectropion, and socket
contraction was determined.
Results The average percent volume replaced by the implants in group 1 patients
was 68%. The average percent volume replaced by the implants in group 2 patients
was 21%. Seventy-one percent of patients in group 2 underwent secondary implant
surgery to augment volume and eliminate superior sulcus deformity and enophthalmos.
Conclusions The placement of an adequately sized implant in pediatric patients may
obviate the need for secondary augmentation of socket volume in adulthood.
The authors suggest an implant 2 mm less in diameter than the axial length
of the eye in pediatric patients.
From the Department of Ophthalmology, University of Virginia, Charlottesville.
RELATED ARTICLE
Archives of Ophthalmology Reader's Choice: Continuing Medical Education
Arch Ophthalmol. 2001;119(3):464.
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