Scleral shield: primary results of a new surgical technique in augmenting porous orbital implant protection.

Abstract

To evaluate the value of using an additional scleral shield in providing further protection of inserted Medpor® implants in eviscerated globes. This was a prospective interventional case series that included 30 patients with blind and/or disfiguring globe that warranted evisceration. Cases with intraocular masses, retained intraocular foreign bodies, as well as secondary ball implantation were excluded. All patients underwent regular evisceration with porous polyethylene ball (Medpor®) implantation. The sutured wound was further covered by scleral patch graft followed by closure of Tenon capsule and conjunctiva in separate layers. Patients were evaluated for implant exposure and all of them completed at least 4 years of follow-up. The study involved 26 male and 4 female participants with age ranging from 16 to 65 years (mean 40.74 ± 15.86 years). The Medpor sizes varied from 16 to 22 mm in diameter. It is a simple extra step with no reported exposure, infection, or granulomas during the 4 years of follow-up. Scleral shield is a simple surgical technique that provides an extra layer of autogenous tissue to cover inserted orbital implant following evisceration with promising results in preventing their exposure.