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July 1989

Primary vs Delayed Implant in Evisceration-Reply

Author Affiliations

San Antonio, Tex

Arch Ophthalmol. 1989;107(7):952-953. doi:10.1001/archopht.1989.01070020014004

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In Reply.  —Drs Holds and Anderson raise an important point concerning the management of patients with endophthalmitis by evisceration—whether to place an alloplastic implant within the scleral pouch at the time of initial surgery.This is a personal decision that the treating surgeon must make after carefully considering many factors, including the risk for extrusion of the implant, the morbidity associated with such an extrusion, and the risk for continued suppuration if an alloplastic implant is placed in an infected scleral bed. To our knowledge, the information put forth by Drs Holds and Anderson is the first data available indicating that the morbidity of primary implantation is low even though the extrusion rate is high (24% in their series). This is promising, but we still need to know if it is possible to identify those patients who are likely to experience extrusion of implants placed in septic scleral pouches. We

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