Dados do Trabalho

Título

An Innovative Proposal for Anophthalmic Cavity Reconstruction Surgery With Bone Cement: A Case Report

Objetivo

To report a case of a patient who underwent evisceration surgery after
spontaneous rupture of the ocular globe due to long-data uncontrolled glaucoma,
with posterior placement of orbital implant made of bone cement, compound based
on polymethylmethacrylate (PMMA).

Relato do Caso

A 65-year-old male patient presented to the ophthalmologic emergency department
at Instituto Doutor José Frota (Fortaleza, Brazil) with spontaneous rupture of the
eye secondary to long-term uncontrolled glaucoma. It was decided to perform
evisceration surgery followed by filling of the anophthalmic socket using bone
cement (Osteo-Class, Baumer, São Paulo, Brazil) due to the lack of alternative
implants in the institution.
This material is a compound based on polymethylmethacrylate (PMMA) and
methylmethacrylate (MMA), therefore inert to the human eye and presents as a
powder (PMMA) with a liquid reagent (MMA) for the preparation of the implant.
After mixing the powder with the reactant, heat is released, and the formed mass
can be molded in the desired shape (in our case spheroid) and the appropriate
size, using a caliper for measuring the ideal ball diameter for implant (Figure1).
The anophthalmic socket was adequately filled with orthopedic cement, providing
proper aesthetic results and suitable conditions for posterior scleral prosthesis
implantation (Figure 2). The patient was reassessed in the immediate
postoperative period and progressed without complications, with discharge
conditions four days after surgery. The patient continued to be followed up, and no
complications were observed with this procedure at ten months of follow-up.

Conclusão

We believe that the use of low-cost alternative materials, such as bone
cement, in the emergency setting may become an alternative in order to
individually restore anophthalmic sockets, allowing better rehabilitation, especially
to low-income individuals who depend on public services. Further well-designed
trials evolving a more significant amount of patients are necessary to confirm the
viability of this proposal.

Área

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