{Reference Type}: Journal Article
{Title}: Long-Term Outcome of Staged Socket Surgery for Acquired Anophthalmos.
{Author}: Vahdani K;Rose GE;Ortiz-Pérez S;Verity DH;
{Journal}: Ophthalmic Plast Reconstr Surg
{Volume}: 40
{Issue}: 3
{Year}: 2024 May-Jun 1
{Factor}: 2.011
{DOI}: 10.1097/IOP.0000000000002566
{Abstract}: <B>OBJECTIVE: </B>To evaluate long-term outcomes of staged volume rehabilitation for acquired anophthalmos.<BR><B>METHODS: </B>Case-note review of patients who had preceding i) eye removal without implant, ii) eye removal with an intraconal implant, but ball-related problems, or iii) removal of exposed implant. Secondary interventions were a) a first-time ball implant, b) dermis-fat graft, c) ball repositioning, d) ball replacement after prior removal, or e) orbital floor implantation.<BR><B>RESULTS: </B>Secondary volume-augmenting surgery was performed in 175 sockets at a mean age of 42.7 years (range 2-91), with 62% secondary ball implants, 3% dermis-fat grafts, 6% ball repositioning, 19% ball replacement after prior removal for exposure, and 10% having orbital floor implantation. After this surgery, further volume enhancement was required in 21% of sockets, this being 40% for spheres ≤18 mm diameter, in contrast to 6% for those ≥20 mm ( p < 0.001). Exposure or malposition of the secondary implant occurred in 8% (12/151) and was unrelated to implant type, size, wrapping, or prior irradiation. Tertiary surgery addressed lining deficiency (18%) or eyelid malposition (25%). Overall, 92/175 (53%) had tertiary surgery to improve cosmesis and comfort, with 49% (36/92) being related to small implants. At a mean follow-up of 9.1 years, 82% of sockets had adequate volume, 79% had excellent lining, and 93% were comfortable. Prosthetic fit was satisfactory in 96% of cases, and 97% reported improved cosmesis.<BR><B>CONCLUSIONS: </B>Over half of the sockets having planned 2-stage volume enhancement may need further procedures, especially after small-volume secondary implants, but, with meticulous surgery, reasonable long-term results can be achieved with few complications.