Evaluation Of The Functional And Cosmetic Outcome Of Enudeation With Rectus End-to-end Suturing Surgical Technique In Coralline Hydroxyapatite Orbital Implants

Objective:To assess the functional and cosmetic outcomes of enucleation with rectus end-to-end suturing surgical technique.Methods:Forty-five patients who underwent enucleation with rectus end-to-end suturing of coralline hydroxyapatite orbital implants by one surgeon. All the patients underwent primary enucleation and implantation of non-wrapped hydroxyapatite implants using a technique that involves drawing the ends of the rectus muscles anteriorly and suturing them into a cross-shape in front of the implant. Main outcome measures included occurrence of pain or discharge, soft tissue problems, implant motility, upper lid position, and patients'satisfaction. Results:The follow-up ranged from 6-51 months (mean,28.3 months).Discharge occurred in 10(22.2%), socket discomfort in 2(4.5%), conjunctival thinning in 3 (6.7%), suture tie exposure in 1 (2.2%), pigment deposition in the inner canthus in 1(2.2%). No patients had implant exposure or infection. Implant motility vertically and horizontally was an average of 7.3 mm and 8.8mm, respectively. All patients considered their prosthesis motility to be acceptable. The average difference between eyes in exophthalmometric measurement and palpebral fissure height was 1.8 mm and 1.4 mm, respectively. Cosmesis with use of a prosthesis was considered excellent by 51% of patients, fair by 40%, and poor by 9%.Conclusion:The rectus end-to-end suturing surgical technique appeared to be a safe and effective modification in hydroxyapatite implantation with no serious complication.