Antimicrobial-eluting cement orbital implant: a case report of staged enucleation for infectious panophthalmitis with extraocular extension

Kevin D. Clauss, Ying Chen, Marissa K. Shoji, Thomas E. Johnson, Roger E. Turbin

Research output: Contribution to journalArticlepeer-review

Abstract

There are various orbital implant options following enucleation. In cases of severe infection, such as panophthalmitis with extraocular extension, it is reasonable to consider a two-staged approach to decrease the risk of infectious complications. One option, illustrated by this case, is enucleation with insertion of an antimicrobial-eluting cement implant, followed by a secondary procedure to exchange the cement with a permanent orbital implant. We report on a patient with clinical, ultrasound, and radiographical findings consistent with infectious panophthalmitis with extra-scleral extension. Intolerable pain and progressive orbital involvement in a blind eye were the indications for enucleation. To reduce the risk of persistent infection, a gentamycin-eluting cement implant (Palacos® R + G as an intraorbital implant) was utilized in the initial procedure. Two months later, the cement implant was removed, and a scleral-wrapped porous implant was placed into a quiet socket without signs of inflammation or infection. In the setting of severe infection, a two-staged procedure utilizing an antimicrobial-eluting implant can be considered.

Original languageEnglish (US)
JournalOrbit (London)
DOIs
StateAccepted/In press - 2021
Externally publishedYes

Keywords

  • Antimicrobial-eluting implant
  • cement implant
  • drug-eluting implant
  • enucleation
  • implant
  • orbit
  • panophthalmitis

ASJC Scopus subject areas

  • Ophthalmology

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