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• W2085087603 abstract "Nakra et al1Nakra T. Ben Simon G.J. Douglas R.S. et al.Comparing outcomes of enucleation and evisceration.Ophthalmology. 2006; 113: 2270-2275Abstract Full Text Full Text PDF PubMed Scopus (56) Google Scholar compared a specific enucleation technique with the traditional evisceration technique. During enucleation, the edges of the rectus muscle insertion were sutured to form a sling anterior to the round implant. The advantages of this technique are the improved implant motility and reduced implant exposure. Nevertheless, we argue that this technique has a major problem that is related to the use of implants that are too small. Specifically, implant size is very important for replacing the loss of volume resulting from globe removal. The loss of volume is obviously more important after enucleation than after evisceration.2Kaltreider S.A. Lucarelli M.J. A simple algorithm for selection of implant size for enucleation and evisceration: a prospective study.Ophthal Plast Reconstr Surg. 2002; 18: 336-341Crossref PubMed Scopus (58) Google Scholar Therefore, a trend to place larger implants after enucleation is evident in the current literature.3Kaltreider S.A. Peake L.R. Carter B.T. Pediatric enucleation: analysis of volume replacement.Arch Ophthalmol. 2001; 119: 379-384Crossref PubMed Scopus (24) Google Scholar Nevertheless, Nakra et al reported no significant difference in implant size between evisceration and enucleation. Therefore, the use of implants that are too small in enucleation may explain their results, in which enucleated patients were more enophthalmic and had a less favorable sulcus contour than those who underwent evisceration. This is a major problem, because a volume deficit is usually related to a poor aesthetic outcome. In some cases, this poor result may even lead to secondary implant replacement with a larger implant. An example of secondary implant replacement is reported (Fig 1 [available at http://aaojournal.org]). Author replyOphthalmologyVol. 114Issue 10PreviewWe thank Goisis et al for their correspondence regarding our study. They assert that we utilized a muscle suturing technique during enucleation that “has a major problem that is related to the use of implants that are too small,” leading to a relative volume deficit. They comment that perhaps this volume deficit explains our results. We appreciate the opportunity to respond to their comments, analyze their references, and review the findings of our study. Full-Text PDF" @default.
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• W2085087603 date "2007-10-01" @default.
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• W2085087603 title "Evisceration vs. Enucleation" @default.
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• W2085087603 doi "https://doi.org/10.1016/j.ophtha.2007.03.001" @default.
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