Pegs, posts raise risk of atypical mycobacterial infection in anophthalmic sockets with exposed porous implants

This study investigates the clinical features of atypical mycobacterial infection in anophthalmic sockets with exposed porous orbital implants.

Study design

The authors reviewed the medical records of 26 patients who had undergone surgical correction of porous orbital implant exposure, including 5 who developed an atypical mycobacterial infection (AM group) and 21 who did not (non-AM group).

Outcomes

Insertion of a peg or a motility-coupling post was the only factor that significantly increased risk of infection. All patients in the AM group had a peg or a post surrounded by an area of implant exposure. All patients with AM also had erythematous eyelid nodules or recurrent exposure after attempted surgical correction. In the non-AM group, only 33.3% of patients had a peg or a post.

Limitations

The use of pegs and posts can improve motility in anophthalmic patients, but the risk of complications has discouraged use of these devices. This report is limited by the small number of cases, but suggests ophthalmologists should carefully monitor patients who have pegs. In addition, the results may not be generalizable because all patients are from Korea, and different organisms may be present in different geographical locations.

Clinical significance

Surgeons should be suspicious of AM infection in anophthalmic patients with implant exposure, especially when a peg or motility coupling post has been placed. Treatment of AM infection requires removal of the implant and long-term antibiotics.