Exposure of primary orbital implants in postenucleation retinoblastoma patients11The authors have no financial or proprietary interest in any of the materials used in this study.

Lee, Vickie; Subak-Sharpe, Ian; Hungerford, J. L.; Davies, Nigel; Logani, Sanjay

doi:10.1016/s0161-6420(00)00016-6

Cited by 70 publications

(23 citation statements)

References 20 publications

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“…Table 3 (available at http://aaojournal.org) summarizes the reported outcomes of pediatric orbital implants with particular focus on retinoblastoma, chemotherapy, and EBRT drawing on published reports that included at least 15 pediatric sockets. 1,2,4,6,13–24 Our cohort, composed predominantly of patients with retinoblastoma, represents one of the few series in which the majority of children received additional cancer treatments. 2,20 Event-free course, defined by absence of exposure, socket contracture, implant migration, implant extrusion, and pyogenic granuloma formation, was seen in 69% of sockets.…”

Section: Discussionmentioning

confidence: 99%

“…4,15,16,18,19,21–24 However, only a few have examined specifically the effect of chemotherapy and radiation on rates of exposure 2,13,14,20 and socket contracture 14 with various implant types. Higher exposure rates are reported with a greater proportion of sockets receiving chemotherapy (22%–50%) 2,13,19,22 and radiation (15%–35%) 2,14,16 compared with studies with few sockets receiving additional therapies (0%–6.1%). 6,15,17,24 Previous reports often failed to reach statistical significance, perhaps because of a small number of patients treated with chemotherapy or EBRT.…”

Section: Discussionmentioning

confidence: 99%

“…25,26 Several other studies observed similar timing of 3.8 to 4 months. 2,15 The resorption of polymer necessary for the biointegration of an implant exposes the abrasive anterior face of HA to the overlying tissues. Exposure may ensue if overlying tissues are compromised by socket irritation with prosthesis, seasonal allergies, or inflammatory reaction with associated upper respiratory infection.…”

Section: Discussionmentioning

confidence: 99%

“…2,12,13 This study reviews all enucleations performed over the past 10 years at St. Jude Children’s Research Hospital, assessing the impact of radiation and chemotherapy on anophthalmic sockets with hydroxyapatite (HA) implants.…”

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confidence: 99%

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The Effect of Cancer Therapies on Pediatric Anophthalmic Sockets

et al. 2011

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Purpose To determine the impact of chemotherapy or external beam radiotherapy (EBRT) on pediatric anophthalmic sockets. Design A retrospective, nonrandomized, interventional cohort study. Participants A total of 135 sockets of 133 children undergoing enucleation from late 1999 to early 2009 at the St. Jude Children’s Research Hospital were included. Methods A retrospective chart review of outcomes after enucleation in patients treated with systemic chemotherapy or orbital EBRT either before or after removal of the eye compared with patients who received no other treatment. Main Outcome Measures Incidence of implant exposure, migration, extrusion, socket contracture, and pyogenic granuloma formation. Results Retinoblastoma was the primary diagnosis in 128 eyes (95%). Median follow-up was 3.6 years (range, 0.1–9.3 years). Event-free course was observed in 94 sockets (69.6%). Complications included implant exposure (n = 28, 20.7%), socket contracture (n = 16, 11.9%), pyogenic granuloma (n = 9, 6.7%), implant extrusion (n = 3, 2.2%), and migration (n = 2, 1.5%). Exposure resolved in 21 sockets (77.8%) and improved in 2 sockets (11.1%); 1 patient with exposure died. Use of prior, adjuvant, or subsequent chemotherapy increased the long-term risk of exposure (odds ratio [OR] = 3.7; 95% confidence interval [CI], 1.4–9.4), and contracture (OR could not be calculated, P<0.0001). External beam radiotherapy greatly increased the risk of contracture (OR 24.0; 95% CI, 6.9–82.8) and exposure (OR 2.89; 95% CI, 1.1–7.9). Conclusions In this unique pediatric population with cancer, chemotherapy and EBRT had an additive effect, significantly increasing the incidence of exposure and socket contracture.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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The Effect of Cancer Therapies on Pediatric Anophthalmic Sockets

et al. 2011

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“…For example, Karcioglu et al3 reported Medpor® exposure in 8 of 37 retinoblastoma patients (21.6%), and Lee et al4 reported exposure in 8 of 13 eyes (53%).…”

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confidence: 99%

The Survival of Freely Grafted Orbital Fat on Porous Polyethylene Orbital Implants in the Rabbit

Kim

Choung

Khwarg

2006

Korean J Ophthalmol

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PurposeTo investigate the long term survival of orbital fat grafted on a Medpor® implant as a method of preventing porous polyethylene orbital implant (Medpor®) exposure in anophthalmic sockets.MethodsIn one orbit in each of 8 rabbits, a small amount of retrobulbar orbital fat was grafted between the anterior surface of the Medpor® implant and overlying conjunctiva, during the enucleation and Medpor® implantation procedure. Two rabbits were sacrificed at 2, 4, 8 and 12 weeks postoperatively and grafted orbital fats were examined by light microscopy.ResultsGrafted orbital fat was well-maintained at 2 and 4 weeks, postoperatively. However, fat amounts were significantly reduced at 8 weeks, and viable fat was barely visible at 12 weeks.ConclusionsIn rabbits, orbital fat grafted on Medpor® implants was gradually resorbed, and the fat-occupied volume was not maintained.

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Pediatric Enucleation, Evisceration, and Exenteration Techniques

Piest¹,

Welsh²

2002

Pediatric Oculoplastic Surgery

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Exposure of primary orbital implants in postenucleation retinoblastoma patients11The authors have no financial or proprietary interest in any of the materials used in this study.

Cited by 70 publications

References 20 publications

The Effect of Cancer Therapies on Pediatric Anophthalmic Sockets

The Effect of Cancer Therapies on Pediatric Anophthalmic Sockets

The Survival of Freely Grafted Orbital Fat on Porous Polyethylene Orbital Implants in the Rabbit

Pediatric Enucleation, Evisceration, and Exenteration Techniques

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