Post Enucleation Socket Management

Abstract

Post enucleation socket syndrome is a combination of features that results from orbital volume deficit and soft tissue changes post enucleation and is characterised by enophthalmos, superior sulcus deformity, ptosis, lower eyelid laxity and backward tilting of the ocular prosthesis. The management of this challenging condition is aimed at achieving an optimal cosmesis with a central implant of adequate volume, an epithelium lined socket, normally functioning eyelids and properly fitted prosthesis. Any change in one of these components may lead to suboptimal cosmesis and function. The most common complications associated with the management of post enucleation socket are exposure and extrusion of the implant, inadequate volume replacement leading to residual enophthalmos and superior sulcus deformity, residual eyelid malpositions, surface deficit and eventually contracted socket. The pathophysiology and correction of each of these problems are discussed.