# Safety and aesthetic outcomes of silicone buckles as an implant for anophthalmic sockets: a decade of experience in Japan

## TL;DR

This study examines the safety and appearance results of using silicone buckles in eye socket reconstruction over ten years in Japan.

## Contribution

The study provides long-term clinical data on silicone buckle #506 for anophthalmic socket reconstruction in Japan.

## Key findings

- Implant exposure occurred in 6.1% of patients with silicone buckles.
- Aesthetic scores improved with more buckles, though differences were not statistically significant.
- Silicone buckle #506 is considered safe and feasible for socket reconstruction.

## Abstract

To investigate the safety and aesthetic outcomes of silicone buckle #506 for anophthalmic socket reconstruction.

Retrospective cohort study.

Patients who underwent enucleation or evisceration at the Osaka University Hospital were retrospectively analyzed. Patients under 18 years old, with < 3 months follow-up, without a prosthesis, or with bilateral surgery were excluded. Aesthetic outcomes were assessed using standardized photographs taken 3 months postoperatively, scored by five independent ophthalmologists for upper eyelid sulcus deepening asymmetry. Scoring was categorized as 0: no noticeable side difference, 1: slight asymmetry, and 2: marked asymmetry characterized by upper eyelid sulcus deepening.

Fifty-nine patients (60 sockets) were analyzed. Thirty-three received silicone buckle implants (1–4 buckles). Implant exposure occurred in two patients (6.1%). Aesthetic scores were assessed in 48 patients. Mean aesthetic scores were 0.97 (no implant), 0.78 (one buckle), 0.68 (two buckles), and 0.42 (three/four buckles) (p = 0.123).

Silicone buckle #506 appears to be a safe and feasible option for anophthalmic socket reconstruction. Further studies are needed to optimize aesthetic outcomes and determine the ideal number of buckles.