Outcome of smooth surface tunnel porous polyethylene orbital implants (Medpor SST) in children with retinoblastoma

Choi, Youn Joo; Park, Chaerin; Jin, Hye Jin; Choung, Ho Kyung; Lee, Min Joung; Kim, Namju; Khwarg, Sang In; Yu, Young Suk

doi:10.1136/bjophthalmol-2013-303481

Cited by 19 publications

(14 citation statements)

References 22 publications

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“…Promising results with the Medpor SST have been reported by Choi et al. () with no exposures in 44 retinoblastoma patients. The latter group is smaller than ours, but otherwise comparable with a substantial subgroup of patients (1/3) that also received additional therapy.…”

Section: Discussionmentioning

confidence: 80%

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Orbital implants in retinoblastoma patients: 23 years of experience and a review of the literature

Mourits

Moll

Bosscha

et al. 2015

Acta Ophthalmologica

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ABSTRACT.Purpose: To evaluate complications of different types of orbital implants following enucleation for retinoblastoma. Methods: We performed a retrospective chart study of all patients that underwent enucleation as treatment of retinoblastoma between April 1991 and June 2013. Events of implant exposure, extrusion (defined as a complete loss of the implant, or a major exposure that could not be closed) and socket abnormalities were analysed for association with implant type and influence of additional external beam radiation therapy (EBRT) and/or chemotherapy. Results: A total of 224 enucleations in 216 patients (eight bilateral) were identified. Mean age at surgery was 1.9 (median 1.5) years. Of the 219 included enucleated eyes, 20 were not replaced by a primary implant and 18 were replaced by an Allen implant. Scleral wrapped hydroxyapatite (HA) and acrylic implants (polymethylmethacrylate) were inserted in, respectively, 79 and 102 cases. In the total population, 29 treatment or implant-specific events (13.2%) were registered. Main complications were implant exposure n = 10 (4.6%) and extrusion n = 6 (2.7%). The acrylic/sclera group had less exposures or extrusions (5 of 102, 4.9%) compared to the HA/sclera group (10 of 79, 12.7%), although this difference did not quite reach statistical significance (p = 0.06). Additional treatment (chemotherapy and/or EBRT for the fellow eye) was administered in 78 cases (35.8%). The overall complication rate in the entire study population was significantly higher (16.7% versus 5.7%) in the group exposed to additional therapy (OR 3.3; 95% CI 1.30-8.36 p = 0.008). This negative effect of additional therapy was also significant in the combined acrylic/HA group (OR 2.9; 95% CI 0.97-8.46 p = 0.048). Conclusion: Our results suggest a favourable outcome for acrylic implants compared to the HA implant. Additional treatment with chemotherapy and/or EBRT is associated with an increased risk of complications.

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Section: Discussionmentioning

confidence: 80%

“…; Choi et al. ; Kirzhner et al. ) and this study, each reporting the results of enucleation and implant insertion in children with retinoblastoma; the table shows the study period of these reports.…”

Section: Reviewmentioning

confidence: 90%

Orbital implants in retinoblastoma patients: 23 years of experience and a review of the literature

Mourits

Moll

Bosscha

et al. 2015

Acta Ophthalmologica

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“…Results of Medpor SST after enucleation for retinoblastoma is as far as we know only published by Choi et al [26] They do indeed report a good outcome with the Medpor SST with no cases of implant exposure, extrusion or infection in a population of 44 children treated for unilateral retinoblastoma, with 34.1% additionally treated with chemotherapy and none with radiotherapy [26]. …”

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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“…Respecto a las complicaciones de la enucleación, nuestra serie reporta una incidencia de ptosis postoperatoria del 9,5% comparado con un 18,2% publicada en un trabajo reciente (Choi et al, 2013). La extrusión del implante orbitario asociado a infección se presentó en 2 (9,5%) pacientes de nuestra serie, comparable con el 21 al 35% de otras series, dependiendo del tratamiento previo 28 .…”

Section: Discussionunclassified

“…La extrusión del implante orbitario asociado a infección se presentó en 2 (9,5%) pacientes de nuestra serie, comparable con el 21 al 35% de otras series, dependiendo del tratamiento previo 28 . Sin embargo, hay reportes en que no tienen casos de extrusión 29,30 .…”

Section: Discussionunclassified

Manejo multidisciplinario en retinoblastoma: experiencia en 37 ojos

Ossandón

Zanolli

Pérez

et al. 2015

Archivos de la Sociedad Española de Oftalmología

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Outcome of smooth surface tunnel porous polyethylene orbital implants (Medpor SST) in children with retinoblastoma

Abstract: Medpor SST is relatively safe, allowing for a mean follow-up of 5 years in terms of implant exposure, and may be a good choice of orbital implant for children with retinoblastoma.

Cited by 19 publications

References 22 publications

Orbital implants in retinoblastoma patients: 23 years of experience and a review of the literature

Orbital implants in retinoblastoma patients: 23 years of experience and a review of the literature

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

Manejo multidisciplinario en retinoblastoma: experiencia en 37 ojos

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