Implant and Prosthesis Movement after Enucleation

Shome, Debraj; Honavar, Santosh G; Raizada, Kuldeep; Raizada, Deepa

doi:10.1016/j.ophtha.2009.12.035

Cited by 52 publications

(56 citation statements)

References 20 publications

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“…139 Comparative studies have shown best artificial eye motility with a simple, cheap, polymethyl methacrylate implant and muscles sutured to the conjunctiva to form the pockets to hold the artificial eye (myoconjunctival approach), which is affordable world-wide. 140,141 Porous implants that become vascularized with muscles sutured to the implant are commonly used but are susceptible to infection and extrusion, and are more costly. Provision of a temporary prosthetic eye at the time of enucleation has a positive psychological impact on families, 19 to help the family accept enucleation for their child.…”

Section: Managementmentioning

confidence: 99%

Retinoblastoma

Dimaras

Corson

Cobrinik

et al. 2015

Nat Rev Dis Primers

468

390

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Retinoblastoma is a rare cancer of the infant retina, which forms when both RB1 alleles mutate in a susceptible retinal cell, likely a cone photoreceptor precursor. Loss of the tumour suppressor functions of the retinoblastoma protein, pRB, leads to uncontrolled cell division and recurrent genomic changes during tumour progression. Although pRB is expressed in virtually all tissues, cone precursors have biochemical and molecular features that may sensitize to RB1 loss to enable tumourigenesis. Retinoblastoma is diagnosed in ~8,000 children each year worldwide. Patient survival is >95% in high-income countries, but <30% globally. However, outcomes are improving through increasing awareness for earlier diagnosis, new guidelines and sharing of expertise. Intra-arterial and intravitreal chemotherapy have emerged as promising methods to salvage eyes. Ongoing international collaborations will replace the multiple different classifications of eye involvement with standardized definitions to consistently assess eligibility, efficacy and safety of treatment options. Life-long follow-up is warranted since survivors of heritable retinoblastoma are at risk for developing second cancers. Defining the molecular consequences of RB1 loss in diverse tissues may open new avenues for treatment and prevention of retinoblastoma as well as second cancers in patients with germline RB1 mutations.

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Section: Managementmentioning

confidence: 99%

Retinoblastoma

Dimaras

Corson

Cobrinik

et al. 2015

Nat Rev Dis Primers

468

390

View full text Add to dashboard Cite

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“…This technique is based on the theory that prosthesis motility is not only a result of the implant motility but also provided by contraction of the fornices. Shome et al [28] compared in a randomized controlled trial with >1 year follow up the traditional muscle imbrication technique using polymethyl methacrylate (PMMA) (n = 50) or porous polyethylene (n = 50) and myoconjunctival technique (n = 50) using PMMA implants. Results of this study demonstrated statistically and clinically significant better implant and prosthesis movement with the PMMA myoconjunctival technique [28].…”

Section: Discussionmentioning

confidence: 99%

“…Shome et al [28] compared in a randomized controlled trial with >1 year follow up the traditional muscle imbrication technique using polymethyl methacrylate (PMMA) (n = 50) or porous polyethylene (n = 50) and myoconjunctival technique (n = 50) using PMMA implants. Results of this study demonstrated statistically and clinically significant better implant and prosthesis movement with the PMMA myoconjunctival technique [28]. Yadava et al [8] confirmed in a randomized controlled trial with 30 patients the superiority of the myoconjunctival technique.…”

Section: Discussionmentioning

confidence: 99%

Worldwide Enucleation Techniques and Materials for Treatment of Retinoblastoma: An International Survey

et al. 2015

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PurposeTo investigate the current practice of enucleation with or without orbital implant for retinoblastoma in countries across the world.MethodsA digital survey identifying operation techniques and material used for orbital implants after enucleation in patients with retinoblastoma.ResultsWe received a response of 58 surgeons in 32 different countries. A primary artificial implant is routinely inserted by 42 (72.4%) surgeons. Ten (17.2%) surgeons leave the socket empty, three (5.2%) decide per case. Other surgeons insert a dermis fat graft as a standard primary implant (n=1), or fill the socket in a standard secondary procedure (n=2; one uses dermis fat grafts and one artificial implants). The choice for porous implants was more frequent than for non-porous implants: 27 (58.7%) and 15 (32.6%), respectively. Both porous and non-porous implant types are used by 4 (8.7%) surgeons. Twenty-five surgeons (54.3%) insert bare implants, 11 (23.9%) use separate wrappings, eight (17.4%) use implants with prefab wrapping and two insert implants with and without wrapping depending on type of implant. Attachment of the muscles to the wrapping or implant (at various locations) is done by 31 (53.4%) surgeons. Eleven (19.0%) use a myoconjunctival technique, nine (15.5%) suture the muscles to each other and seven (12.1%) do not reattach the muscles. Measures to improve volume are implant exchange at an older age (n=4), the use of Restylane SQ (n=1) and osmotic expanders (n=1). Pegging is done by two surgeons.ConclusionNo (worldwide) consensus exists about the use of material and techniques for enucleation for the treatment of retinoblastoma. Considerations for the use of different techniques are discussed.

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“…Decision to enucleate an eye or treat with chemotherapy was made after a joint consultation between the treating ophthalmologist/s and medical oncologist/s. Implants used after enucleations were vicryl mesh-coated hydroxyapatite, to which the extraocular muscles were attached, or acrylic, in which cases a myoconjunctival technique was used 10. The presence of high-risk features for systemic spread on histopathological evaluation11 prompted treatment with adjuvant IVC.…”

Section: Methodsmentioning

confidence: 99%