Evisceration With Primary Orbital Implant In Blind Eyes With Endophthalmitis/Panophthalmitis Versus That In Blind Eyes without Infection

1. Devjyoti Tripathy MS¹
2. Guy J. Ben Simon MD²

¹Priyamvada Birla Aravind Eye Hospital, Kolkata, India
²Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel

Purpose
To compare the outcome of cases of blind eyes with endophthalmitis and panophthalmitis undergoing evisceration with primary orbital implant with cases of blind eyes without infection undergoing the same surgical procedure.

Methods
Retrospective comparative case series. Records of a total of 18 consecutive patients (10 infectious and 8 non-infectious cases) who underwent evisceration with primary orbital implant at a single center by a single surgeon over a three year period were reviewed. The following were evaluated: persistent inflammation and infection, intraoperative and postoperative complications and successful fitting of prosthesis.

Results
Implant extrusion was seen in one case each in both groups. One case in the non-infectious group had implant exposure. Other minor complications like conjunctival dehiscence and cyst formation were commoner in the infectious group (4 out of 10 cases) than in the non-infectious group (none out of 8 cases). All 18 patients underwent successful prosthesis fitting. Comparing the complication rates between the infectious and the non-infectious groups using the Chi-square test, a p value of 0.278 (p > 0.05, not significant) was obtained.

Conclusion
Based on the comparable rate of complications between the infectious and non-infectious groups as preliminarily evident here, evisceration with primary orbital implant may be offered as a feasible surgical procedure for patients with fulminant endophthalmitis or panophthalmitis. However, it has to be noted here that both sample groups for this study were small and larger sample groups in each category have to be studied to prove the feasibility of this surgical procedure more conclusively.