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Temporary suture tarsorrhaphy at the time of orbital ball implantation

  • Oculoplastics and Orbit
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

Conjunctival chemosis is a common, usually benign, complication of ocular and oculoplastic surgery. After enucleation, evisceration, or secondary ball implant, however, conjunctival edema can cause conformer extrusion, forniceal eversion, and shortening which may complicate the future fitting of a prosthesis. This longitudinal chart review aimed to estimate the efficacy of a temporary suture tarsorrhaphy to minimize postoperative edema and improve conformer retention.

Methods

We retrospectively reviewed the charts of 415 consecutive patients undergoing enucleation, evisceration, and secondary ball implantation between 1990 and 2016. Three-hundred twenty-eight patients had complete data which was analyzed for age, gender, surgical details, complications, and follow-up.

Results

We identified 328 eyes that underwent enucleation (48%), evisceration (3%), or secondary implantation (49%) during the study period. Eighty-nine patients had a suture tarsorrhaphy at the time of surgery, and 239 did not. There was a statistically significant incidence of postoperative conjunctival edema in the no tarsorrhaphy group. There was also a significantly increased rate of conformer loss associated with conjunctival edema. Need for further surgery was not uncommon with 64% and 43% of patients requiring a secondary procedure in the no tarsorrhaphy and tarsorrhaphy groups respectively.

Conclusions

Temporary suture tarsorrhaphy is a simple and effective procedure that reduces conjunctival edema and increases conformer stability when performed at the time of enucleation, evisceration, or secondary ball implantation.

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References

  1. Moshfeghi DM, Moshfeghi AA, Finger PT (2000) Enucleation. Surv Ophthalmol 44(4):277–301

    Article  CAS  Google Scholar 

  2. Meltzer MA (1992) Complications of enucleation and evisceration: prevention and treatment. Int Ophthalmol Clin 32(4):213–233

    Article  CAS  Google Scholar 

  3. Malone TJ, Tse DT (1990) Surgical treatment of chemotic conjunctival prolapse following vitreoretinal surgery. Arch Ophthalmol 108(6):890–891

    Article  CAS  Google Scholar 

  4. Jordan D, Klapper S (2012) Enucleation, evisceration, secondary orbital implantation. In: Black E, Nesi F, Clavano C et al (eds) Smith and Nesi’s ophthalmic plastic and reconstructive surgery, 3rd edn. Springer, New York, pp 1105–1131

    Chapter  Google Scholar 

  5. Walter WL (1985) Update on enucleation and evisceration surgery. Ophthal Plast Reconstr Surg 1(4):243–252

    Article  CAS  Google Scholar 

  6. Quaranta-Leoni FM, Sposato S, Lorenzano D (2015) Secondary orbital ball implants after enucleation and evisceration: surgical management, morbidity, and long-term outcome. Ophthal Plast Reconstr Surg 31(2):115–118

    Article  Google Scholar 

  7. Kostick DA, Linberg JV (1995) Evisceration with hydroxyapatite implant. Surgical technique and review of 31 case reports. Ophthalmology 102(10):1542–1548 discussion 48–9

    Article  CAS  Google Scholar 

  8. Wang JK, Liao SL, Lai PC et al (2007) Prevention of exposure of porous orbital implants following enucleation. Am J Ophthalmol 143(1):61–67

    Article  Google Scholar 

  9. Kaltreider SA, Lucarelli MJ (2002) A simple algorithm for selection of implant size for enucleation and evisceration: a prospective study. Ophthal Plast Reconstr Surg 18(5):336–341

    Article  Google Scholar 

  10. Mules PH (1885) Evisceration of the globe with artificial vitreous. Trans Ophthalmic Soc UK 5:200

    Google Scholar 

  11. Rapoza PA, Harrison DA, Bussa JJ et al (1993) Temporary sutured tube-tarsorrhaphy: reversible eyelid closure technique. Ophthalmic Surg 24(5):328–330

    CAS  PubMed  Google Scholar 

  12. Thaller VT, Vahdani K (2016) Tarsal suture tarsorrhaphy: quick, safe and effective corneal protection. Orbit 35(6):299–304

    Article  Google Scholar 

  13. Custer PL, McCaffery S (2006) Complications of sclera-covered enucleation implants. Ophthal Plast Reconstr Surg 22(4):269–273

    Article  Google Scholar 

  14. Brown SI (1969) An improved tarsorrhaphy technique and its therapeutic applications. Arch Ophthalmol 81(5):710–711

    Article  CAS  Google Scholar 

  15. Fox SA (1961) A new tarsorrhaphy suture. Arch Ophthalmol 66:833–834

    Article  CAS  Google Scholar 

  16. Sundelin KC, Dafgard Kopp EME (2015) Complications associated with secondary orbital implantations. Arch Ophthalmol 93:679–683

    Google Scholar 

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Author information

Authors and Affiliations

  1. University of Queensland, Brisbane, QLD, Australia

    Lindsay A. McGrath

  2. Orbital Plastic and Lacrimal Clinic, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, 3002, Australia

    Lindsay A. McGrath & Alan A. McNab

  3. Centre for Eye Research Australia, University of Melbourne, Melbourne, VIC, Australia

    Alan A. McNab

Authors
  1. Lindsay A. McGrath
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  2. Alan A. McNab
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Corresponding author

Correspondence to Lindsay A. McGrath.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments. Given this was a retrospective study, formal consent was not required.

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McGrath, L.A., McNab, A.A. Temporary suture tarsorrhaphy at the time of orbital ball implantation. Graefes Arch Clin Exp Ophthalmol 256, 2437–2441 (2018). https://doi.org/10.1007/s00417-018-4090-x

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  • DOI: https://doi.org/10.1007/s00417-018-4090-x

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