Predicting the ideal implant size before enucleation

Purpose: This study of volume replacement in anophthalmic sockets compares the volume replaced by the implant and prosthesis with the volume removed f rom the socket and evaluates A-scan ultrasonography as a tool to predict an ideal implant size before enucleation. Methods: In this retrospective study of 59 anophthalmic patients, the volum e replaced by the implant and the prosthesis was compared with the volume o f the enucleated eye. The volume removed was estimated by calculating the v olume of the fellow eye using A-scan ultrasonography. Enophthalmos and supe rior sulcus deformity were measured and correlated with the percent volume replacement in the anophthalmic sockets. Results: Greater enophthalmos and superior sulcus deformity were found in p atients with less than 100% volume replacement compared with those with 100 % or more volume replacement. The axial length determined by A-scan ultraso nography of the fellow eye suggested that a larger implant size should have been placed in 76.3% of those patients with less than 100% volume replacem ent. Sixty-three percent of adult patients could have received an implant m ore than 22 mm in diameter to fill 80% of the volume removed at enucleation . Conclusions: A-scan ultrasonography of the fellow eye provides a useful too l for predicting the implant size before surgery for optimal volume replace ment.