Porous Versus Nonporous Orbital Implants After Enucleation for Uveal Melanoma: A Randomized Study
To compare hydroxyapatite with acrylic implants after enucleation for uveal melanoma with respect to eyelid position, ocular motility, implant complications, and patient satisfaction. Patients undergoing primary enucleation for uveal melanoma between May 2005 and November 2012 at the Liverpool Ocula...
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| Vydané v: | Ophthalmic plastic and reconstructive surgery Ročník 33; číslo 6; s. 452 - 458 |
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| Hlavní autori: | , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
| Vydavateľské údaje: |
United States
01.11.2017
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| ISSN: | 1537-2677 |
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| Abstract | To compare hydroxyapatite with acrylic implants after enucleation for uveal melanoma with respect to eyelid position, ocular motility, implant complications, and patient satisfaction.
Patients undergoing primary enucleation for uveal melanoma between May 2005 and November 2012 at the Liverpool Ocular Oncology Centre, United Kingdom, were randomized between hydroxyapatite and acrylic implants. Questionnaires were sent to patients and ocularists to comment on the main outcomes.
A total of 416 patients were recruited in the study, of whom 281 were included, with 49.5% (139/281) and 50.5% (142/281) receiving a hydroxyapatite (HA) or acrylic (AC) implant. Mailed questionnaires completed at ≥18 months by patients showed no significant differences between the groups in eyelid position, prosthetic motility, socket complications, and patient satisfaction. Complications included implant extrusion (1% vs 4%), enophthalmos (26% vs 26%), and superior sulcus deformity (24% vs 24%) with HA and AC implants, respectively, (Fisher exact test p > 0.0125 in all, Bonferroni correction). Questionnaires completed by ocularists indicated no significant differences in eyelid opening, prosthetic motility, and other complications at 6 months (Fisher exact test, p > 0.05 in all); there was a higher prevalence of ptosis with AC than HA implants (46% vs 25%, p = 0.03) and a greater need for ocularists' treatment with HA than AC (50% vs 28%, p = 0.03).
Patient-reported outcomes after enucleation for uveal melanoma indicate no major differences between hydroxyapatite and acrylic implants in surgical outcomes and patient satisfaction. There was a higher prevalence of ptosis with AC and a greater need of ocularists' visits with HA at around 6 months observed by ocularists. |
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| AbstractList | To compare hydroxyapatite with acrylic implants after enucleation for uveal melanoma with respect to eyelid position, ocular motility, implant complications, and patient satisfaction.
Patients undergoing primary enucleation for uveal melanoma between May 2005 and November 2012 at the Liverpool Ocular Oncology Centre, United Kingdom, were randomized between hydroxyapatite and acrylic implants. Questionnaires were sent to patients and ocularists to comment on the main outcomes.
A total of 416 patients were recruited in the study, of whom 281 were included, with 49.5% (139/281) and 50.5% (142/281) receiving a hydroxyapatite (HA) or acrylic (AC) implant. Mailed questionnaires completed at ≥18 months by patients showed no significant differences between the groups in eyelid position, prosthetic motility, socket complications, and patient satisfaction. Complications included implant extrusion (1% vs 4%), enophthalmos (26% vs 26%), and superior sulcus deformity (24% vs 24%) with HA and AC implants, respectively, (Fisher exact test p > 0.0125 in all, Bonferroni correction). Questionnaires completed by ocularists indicated no significant differences in eyelid opening, prosthetic motility, and other complications at 6 months (Fisher exact test, p > 0.05 in all); there was a higher prevalence of ptosis with AC than HA implants (46% vs 25%, p = 0.03) and a greater need for ocularists' treatment with HA than AC (50% vs 28%, p = 0.03).
Patient-reported outcomes after enucleation for uveal melanoma indicate no major differences between hydroxyapatite and acrylic implants in surgical outcomes and patient satisfaction. There was a higher prevalence of ptosis with AC and a greater need of ocularists' visits with HA at around 6 months observed by ocularists. PURPOSETo compare hydroxyapatite with acrylic implants after enucleation for uveal melanoma with respect to eyelid position, ocular motility, implant complications, and patient satisfaction.METHODSPatients undergoing primary enucleation for uveal melanoma between May 2005 and November 2012 at the Liverpool Ocular Oncology Centre, United Kingdom, were randomized between hydroxyapatite and acrylic implants. Questionnaires were sent to patients and ocularists to comment on the main outcomes.RESULTSA total of 416 patients were recruited in the study, of whom 281 were included, with 49.5% (139/281) and 50.5% (142/281) receiving a hydroxyapatite (HA) or acrylic (AC) implant. Mailed questionnaires completed at ≥18 months by patients showed no significant differences between the groups in eyelid position, prosthetic motility, socket complications, and patient satisfaction. Complications included implant extrusion (1% vs 4%), enophthalmos (26% vs 26%), and superior sulcus deformity (24% vs 24%) with HA and AC implants, respectively, (Fisher exact test p > 0.0125 in all, Bonferroni correction). Questionnaires completed by ocularists indicated no significant differences in eyelid opening, prosthetic motility, and other complications at 6 months (Fisher exact test, p > 0.05 in all); there was a higher prevalence of ptosis with AC than HA implants (46% vs 25%, p = 0.03) and a greater need for ocularists' treatment with HA than AC (50% vs 28%, p = 0.03).CONCLUSIONSPatient-reported outcomes after enucleation for uveal melanoma indicate no major differences between hydroxyapatite and acrylic implants in surgical outcomes and patient satisfaction. There was a higher prevalence of ptosis with AC and a greater need of ocularists' visits with HA at around 6 months observed by ocularists. |
| Author | Ho, Vivian W M Czanner, Gabriela Heimann, Heinrich Damato, Bertil E Hussain, Rumana N Sen, Julia |
| Author_xml | – sequence: 1 givenname: Vivian W M surname: Ho fullname: Ho, Vivian W M organization: Liverpool Ocular Oncology Centre, Royal Liverpool University Hospital, Liverpool, United Kingdom; †Department of Biostatistics and Department of Eye and Vision Science, University of Liverpool, Liverpool, United Kingdom; ‡Ophthalmology Department, Alexandra Hospital, Worcestershire Acute NHS Trust, Redditch, United Kingdom; and §Ocular Oncology Service, University of California, San Francisco, California, U.S.A – sequence: 2 givenname: Rumana N surname: Hussain fullname: Hussain, Rumana N – sequence: 3 givenname: Gabriela surname: Czanner fullname: Czanner, Gabriela – sequence: 4 givenname: Julia surname: Sen fullname: Sen, Julia – sequence: 5 givenname: Heinrich surname: Heimann fullname: Heimann, Heinrich – sequence: 6 givenname: Bertil E surname: Damato fullname: Damato, Bertil E |
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| Snippet | To compare hydroxyapatite with acrylic implants after enucleation for uveal melanoma with respect to eyelid position, ocular motility, implant complications,... PURPOSETo compare hydroxyapatite with acrylic implants after enucleation for uveal melanoma with respect to eyelid position, ocular motility, implant... |
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| SubjectTerms | Adolescent Adult Aged Aged, 80 and over Durapatite Eye Enucleation Female Follow-Up Studies Humans Male Melanoma - surgery Middle Aged Orbital Implants Patient Satisfaction Polymethyl Methacrylate Porosity Prosthesis Design Prosthesis Implantation - methods Reoperation Retrospective Studies Surveys and Questionnaires Treatment Outcome Uveal Neoplasms - surgery Young Adult |
| Title | Porous Versus Nonporous Orbital Implants After Enucleation for Uveal Melanoma: A Randomized Study |
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