J Korean Ophthalmol Soc.  2014 Jul;55(7):958-962.

Comparison of Evisceration with Primary Orbital Implant Surgery in Endophthalmitis and Phthisis Bulbi

• Jung JH
• Lee JH
• Jeon HS
• Choi HY

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.

Keyword

Endophthalmitis; Evisceration; Phthisis bulbi

MeSH Terms

Busan
Endophthalmitis*
Follow-Up Studies
Humans
Medical Records
Orbital Implants*
Prevalence
Prognosis
Retrospective Studies

Reference

References

1. Kim JY, Wang SJ, Park CJ, Lee SB. Risk factors leading to enucleation or evisceration in endophthalmitis. J Korean Ophthalmol Soc. 2007; 48:1362–8.

2. Dresner SC, Karesh JW. Primary implant placement with evisceration in patients with endophthalmitis. Ophthalmology. 2000; 107:1661–4. discussion 1664-5.

3. Shore JW, Dieckert JP, Levine MR. Delayed primary wound closure. Use to prevent implant extrusion following evisceration for endophthalmitis. Arch Ophthalmol. 1988; 106:1303–8.

4. HUGHES WL. Evisceration. Arch Ophthalmol. 1960; 63:36–40.

5. Migliori ME. Enucleation versus evisceration. Curr Opin Ophthalmol. 2002; 13:298–302.

6. Afran SI, Budenz DL, Albert DM. Does enucleation in the presence of endophthalmitis increase the risk of postoperative meningitis. Ophthalmology. 1987; 94:235–7.

7. Robson MC, Duke WF, Krizek TJ. Rapid bacterial screening in the treatment of civilian wounds. J Surg Res. 1973; 14:426–30.

8. Tawfik HA, Budin H. Evisceration with primary implant placement in patients with endophthalmitis. Ophthalmology. 2007; 114:1100–3.

9. Park YG, Paik JS, Yang SW. The results of evisceration with primary porous implant placement in patients with endophthalmitis. Korean J Ophthalmol. 2010; 24:279–83.

10. Hui JI. Outcomes of orbital implants after evisceration and enucleation in patients with endophthalmitis. Curr Opin Ophthalmol. 2010; 21:375–9.

11. Huh YS, Chung HS, Son JH. Evisceration for intractable endoge-nous endophthalmitis. J Korean Ophthalmol Soc. 2008; 49:396–400.

12. Son DH, Choi YJ, Ryou JH, Kim SJ. The clinical study of the exposure of implant after evisceration. J Korean Ophthalmol Soc. 2004; 45:887–92.