Myoconjunctival Enucleation Study (MES): Outcome of Myoconjunctival enucleation technique with polymethyl Metha acrylate (PMMA) implant with custom made prosthesis (CMP) in tertiary eye care center in Nepal

PurposeThis study aims to evaluate the average motility of the implant and custom-made prosthesis after MES, the surgical duration, and the complications encountered during the procedure at a tertiary eye hospital. MethodsThis was a prospective, non-randomized interventional study. The muscles were sutured to the fornices before the enucleation of the eyeball to minimize surgical time and the need for additional sutures. 35 consecutive patients meeting the inclusion criteria were enrolled in the study. Data on surgery time, complication rates, and implant/prosthesis motility were recorded and analyzed. ResultsThe mean surgery duration was 39.3 {+/-} 3.76 minutes. The mean movement of the PMMA implant was 2.34 mm in elevation, 2.25 mm in depression, 2.74 mm in abduction, and 2.71 mm in adduction. The mean movement of the custom-made prosthesis was 2.45 mm in elevation, 2.62 mm in depression, 2.74 mm in adduction, and 2.82 mm in abduction. Complications were minimal: one intraoperative superior rectus slippage, few cases with early postoperative nausea, vomiting, and headache, all resolving within a week. At six weeks, one case each of suture granuloma and shallow inferior fornix was noted and managed successfully. Patient satisfaction was high (91.94%), with a mean score of 4.25 {+/-} 0.65. Minimal dissatisfaction was linked to low motility or mild socket contraction. ConclusionMyoconjunctival enucleation offers favorable implant and prosthesis motility, a relatively short surgical duration, and minimal complications. High patient satisfaction further supports its efficacy as a reliable enucleation technique.