Pediatric enucleation - Analysis of volume replacement

Objectives: To determine the percent volume replacement by an implant and p rosthesis, the long-term sequelae of poor volume replacement, and specific guidelines for volume replacement in pediatric patients. Methods: A retrospective observational study of 16 pediatric patients who u nderwent enucleation (group 1) and 31 adult patients enucleated in childhoo d (group 2) was performed. The total volume replacement and the volume repl acement by the implant were determined. The incidence of secondary surgical procedures for superior sulcus deformity, enophthalmos, ptosis, ectropion, and socket contraction was determined. Results: The average percent volume replaced by the implants in group 1 pat ients was 68%. The average percent volume replaced by the implants in group 2 patients was 21%. Seventy-one percent of patients in group 2 underwent s econdary implant surgery to augment volume and eliminate superior sulcus de formity and enophthalmos. Conclusions: The placement of an adequately sized implant in pediatric pati ents may obviate the need for secondary augmentation of socket volume in ad ulthood. The authors suggest an implant 2 mm less in diameter than the axia l length of the eye in pediatric patients.