Outcomes of primary orbital implantation in evisceration/enucleation in patients with endophthalmitis in a tertiary hospital.

PURPOSE: To evaluate the safety and outcomes of primary orbital implantation during evisceration/enucleation for endophthalmitis, specifically analyzing the risk of implant exposure/extrusion.

METHODS

Retrospective review of 98 endophthalmitis patients (90 eviscerations, 8 enucleations) who received a primary orbital implant (mostly PMMA) over 10 years. Follow-up averaged 27.5 months.

RESULTS

Postoperative implant exposure/extrusion occurred in 10 patients (10.2%). This rate is comparable to established literature. The mean time to exposure was 140 days. Neither preoperative orbital cellulitis nor culture positivity (e.g., Pseudomonas) was statistically associated with a higher risk of exposure. Re-operations for exposure did not show evidence of active, ongoing infection.

CONCLUSION

Primary orbital implantation in endophthalmitis patients is safe, carrying an exposure/extrusion risk (10.2%) comparable to reported rates. The procedure should be favored over a two-staged approach unless significant inflammation is noted intraoperatively. PRéCIS: The purpose of this paper is to study outcomes of primary orbital implantation in Endophthalmitis patient, and to review the exposure rate, and to also analyze possible risk factors for the exposure/extrusion.