ENUCLEATION IN MALIGNANT CHOROIDAL MELANOMA - results in 15 years of using a new material in the prosthesis of the orbital cavity

RATIONALE Enucleation implants are covered with a material that allows the fixation of the extraocular rectus muscles. Usually, the implants are covered in donor sclera, which implies the risk of infection transmission, inflammation and implant rejection, being also an expensive procedure. The new materials used for implant meshing should be tested and a safer and cost effective solution should be researched. OBJECTIVE This study presents the results obtained after a 15-year use of an original prosthesis for the reconstruction of the orbital cavity after enucleation surgery. METHODS AND RESULTS 42 eyes of 42 patients who underwent enucleation surgery for choroidal malignant melanoma were included in the study. The surgical technique was very similar to the classic enucleation, the major difference being the implant of a prosthesis made out of a Polymethyl methacrylate (PMMA) ball covered by a Polyethylene terephthalate (dacron) shell used in cardiovascular surgery. All the patients had a very good technical result, without the inflammation of the orbital cavity, conjunctiva or eyelids, which demonstrates a very high material tolerability and an excellent cosmetic result. Late implant expulsion appeared in 7.14% of the patients (3 cases). DISCUSSION The particularly good results obtained by using this technique, the absence of an inflammatory reaction after surgery, and the long lasting stability of the implant, recommend the method as being safe, with no major complications and a good esthetic result.