Journal List > J Korean Ophthalmol Soc > v.55(7) > 1010011

Jung, Lee, Jeon, and Choi: Comparison of Evisceration with Primary Orbital Implant Surgery in Endophthalmitis and Phthisis Bulbi

Abstract

Purpose

To evaluate the efficacy and prognosis of evisceration with primary orbital implant placement in patients with endophthalmitis and compare it to phthisis bulbi patients.

Methods

We retrospectively reviewed the medical records of patients who underwent evisceration with primary implant placement by a single surgeon from January 2005 to December 2011 at Pusan National University Hospital. Age, gender, underlying ocular disease, systemic illness, type and size of implant, follow-up period, and the causative organism were evaluated in patients with endophthalmitis. Success rates and prevalence of complications were compared between endophthalmitis and phthisis patients.

Results

The present study included 18 patients (18 eyes) with endophthalmitis and 23 patients (23 eyes) with phthisis. Patients in the endophthalmitis group were older than the patients in the phthisis group and no significant differences in gender, size of implant, and underlying diseases between endophthalmitis and phthisis patients were found. Sixteen endophthalmitis and 20 phthisis patients showed successful surgical outcomes with no significant differences (p = 0.31), and implant exchange rates were not significantly different between endophthalmitis and phthisis bulbi patients (p = 0.52).

Conclusions

Evisceration with primary orbital implant placement in patients with endophthalmitis is a safe and effective treatment method. Comparison between endophthalmitis and phthisis showed no significant differences in success outcomes and complication rates.

References

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Table 1.
Data of patients
Endophthalmitis Phthisis p-value
No. of patients 18 23
Age (years) 68.8 ± 12.5 46.3 ± 19.4 0.04
Sex (n)
  Male 10 13 0.24
  Female 8 10 0.19
Laterality (n)
  OD 5 10
  OS 13 13
DM (n) 6 3 0.15
Implant (n)
  Hydroxyapatite 9 6 0.43
  Silicone ball 3 2 0.35
  Medpore 6 15 0.55
Implant size (mm) 19.4 ± 1.1 18.3 ± 0.5 0.44
Follow up period (months) 9.61 ± 8.20 11.44 ± 9.47

Values are presented as mean ± SD.

OD = right; OS = left; DM = diabetes mellitus.

Table 2.
Culture results of the endophthalmitis
Organisms Number
Staphylococcus aureus 1
Staphylococcus epidermidis 1
Streptococcus agalactiae 1
Streptococcus pseumoniae 1
Pseudomonas aeruginosa 2
Aspergillus 1
No growth 11
Total 18
Table 3.
Patients characteristics of endophthalmitis and phthisis group
Endophthalmitis Phthisis p-value
Successful outcome at 1st operation (%) 16/18 (88.9) 20/23 (86.95) 0.31
Postoperative complications (n/total) 2/18 3/23 0.52
  Infection 1/18 -
  Fornix insufficiency 1/18 1/23
  Pyogenic granuloma - 1/23
  Exposure - 1/23
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