Aim: To evaluate current clinical practice in the UK in the management of the anophthalmic socket; choice of enucleation, evisceration, type of orbital implant, wrap, motility pegging and complications. Methods: All consultant ophthalmologists in the UK were surveyed by postal questionnaire. Questions included their practice subspecialty and number of enucleations and eviscerations performed in 2003. Specific questions addressed choice of implant, wrap, motility pegging and complications. Results: 456/896 (51%) consultants responded, of which 162 (35%) had a specific interest in oculoplastics, lacrimal, orbits or oncology. Only 243/456 (53%) did enucleations or eviscerations. 92% inserted an orbital implant after primary enucleation, 69% after non-endophthalmitis evisceration, whereas only 43% did so after evisceration for endophthalmitis (50% as a delayed procedure). 55% used porous orbital implants (porous polyethylene, hydroxyapatite or alumina) as their first choice and 42% used acrylic. Most implants inserted were spherical, sized 18-20 mm in diameter. 57% wrapped the implant after enucleation, using salvaged autogenous sclera (20%), donor sclera (28%) and synthetic Vicryl or Mersilene mesh (42%). A minority (7%) placed motility pegs in selected cases, usually as a secondary procedure. 14% of respondents reported implant exposure for each type of procedure and extrusion was reported by 4% after enucleation and 3% after evisceration. Conclusions: This survey highlights contemporary anophthalmic socket practice in the UK. Most surgeons use porous orbital implants with a synthetic wrap after enucleation and only few perform motility pegging. E nucleation or evisceration is performed for various endstage eye diseases. The aim is to remove the diseased eye, provide adequate comfort, replace volume and give good functional and cosmetic appearance.Two surveys have been conducted to evaluate trends in the management of the anophthalmic socket among oculoplastic surgeons in North America 1 2 and one among ocularists in Germany.3 As there is sparse comparable information for the UK, we aimed to collect information of enucleation and evisceration management by postal survey of all consultant ophthalmologists in the UK regarding their preferred clinical practice. MATERIALS AND METHODSA questionnaire of anophthalmic socket management in the year 2003 was sent in April and May 2004 to all 896 consultant ophthalmologists in the UK, listed by The Royal College of Ophthalmologists, regardless of their subspecialty. Respondents were requested to return their completed questionnaire in a prepaid envelope, no reminders were sent and anonymity was maintained. Data management and analysis was performed using Microsoft Access and Excel software. RESULTSOf the 896 consultant ophthalmologists in the UK, 456 responded giving a response rate of 51%. Of these 456, 321 (70%) had an interest in more than one ophthalmic subspecialty. But, overall, 135 (30%) had a special interest in one or more of oncology, oculoplastics, lacrimal or orb...

No abstract