Orbital Implants : Review of Results obtained at the Moorfields Branch of the Moorfields, Westminster and Central Eye Hospital, London

Abstract

ENUCLEATION of an eye is likely to remain one of the commoner ophthalmic procedures. Out of approximately 4,000 operations performed at the Moorfields branch of the Moorfields, Westminster and Central Eye Hospital in 1950, 200 were for excision of an eye. A number of these were blind, painful eyes-thrombotic glaucoma, for example-in elderly people, in whom cosmetic considerations would be satisfied by an ordinary painted shell for the socket. These patients were commonly very grateful for the operation. Many of the remaining eyes were excised either after severe injury resulting in a disorganized and possibly dangerous globe, or for choroidal sarcoma. Here the patients not only lose what may well be a good seeing eye, but they are also much concerned with their post-operative appearance. Many of these patients are young, with their careers before them, and their future could well be affected by having an obviously false eye.The recent war stimulated a great deal of work on movable ocular prostheses. Buried implants-of glass, ivory, and more recently of plastic material-impart an appreciable amount of movement to an overlying shell, provided that the muscles are sutured to or across the top of the implant. Nevertheless, recent work has moved away from the concept of the buried implant in favour of the integrated implant, in which the anterior surface is left exposed for direct contact with the painted shell (Reudemann, 1945; Cutler, 1947 Cutler, , 1949Hudson, 1950; Stone, 1951

Enucleation combined with orbital implants for malignant melanoma of the uvea

“…Magnetic fixation of prosthesis with implant through the conjunctiva is also possible. Such implants are not advised any more due to common complications such as secondary infection or decubitat necrosis of the conjunctiva [2,14,27].…”

“…After occasional early loss of the implant due to intolerance, dislocation or secondary infection, many surgeons became more careful in the use of orbital implants [2,14,27].…”

Surgical Advances and Techniques

“…This proved a sad failure (Choyce 1952) and it rang the knell of all exposed implants. However, in 1960 I became aware that several of the original implants were still giving good service and decided to give it a further trial.…”

Magnetic Orbital Implant

“…The satisfactory way in which these implants are retained in the orbit is demonstrated by the large number which have now more than fulfilled the 2-year follow-up period suggested by Choyce (1952). The retention of the magnetic form of implant appears to be as good as that of the non-magnetic form.…”