{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T06:51:32Z","timestamp":1775631092815,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,7,7]],"date-time":"2021-07-07T00:00:00Z","timestamp":1625616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate medical conditions and systemic therapies associated with orbital implant exposure in patients with anophthalmic sockets.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective review of patients who underwent enucleation or evisceration at a single centre between January 1, 2008 and March 1, 2018. Medical comorbidities, including peripheral or coronary artery disease, rheumatologic conditions, diabetes, malignancy and history of smoking were recorded. Use of immunomodulatory and anticoagulation therapy at the time of eye removal was noted. Patients were divided into two groups\u2014those with implant exposure and those without. Univariate and multivariate analysis was used to compare groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred and twenty\u2010nine patients underwent eye removal surgery over a ten\u2010year period. Implant exposure was seen in 20 (8.7%) patients. Univariate analysis revealed a statistically significant difference between groups in rates of smoking, malignancy, and immunomodulatory therapy at the time of surgery. A history of smoking (HR\u2009=\u200911.72; 95% CI: 2.95, 46.53; p\u2009=\u20090.0001) and immunomodulatory therapy (HR\u2009=\u20098.02; 95% CI: 1.96, 32.87; p\u2009=\u20090.004) were independent predictors of exposure. The probability of exposure was 81.2% when all three risk factors were present versus 4.4% when none were present (c\u2010index\u2009=\u20090.737, 95% CI: 0.608, 0.865; p\u2009&lt;\u20090.001). The model was a good fit to the data (Hosmer\u2010Lemeshow goodness\u2010of\u2010fit test p\u2009=\u20090.475).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Smoking and immunomodulatory therapy were associated with orbital implant exposure in patients with anophthalmic sockets. This is the first report examining medical comorbidities in patients with orbital implant exposure. Understanding the pathophysiology of implant exposure is crucial to preoperative planning and postoperative care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.14973","type":"journal-article","created":{"date-parts":[[2021,7,7]],"date-time":"2021-07-07T19:50:13Z","timestamp":1625687413000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Medical comorbidities and orbital implant exposure"],"prefix":"10.1111","volume":"100","author":[{"given":"Larissa A.","family":"Habib","sequence":"first","affiliation":[{"name":"Oculoplastic and Reconstructive Surgery Division Department of Ophthalmology Yale Medical School  New Haven CT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4173-4671","authenticated-orcid":false,"given":"Victoria S.","family":"North","sequence":"additional","affiliation":[{"name":"Oculoplastic and Orbital Surgery Edward S. Harkness Eye Institute Columbia University Irving Medical Center New York\u2010Presbyterian Hospital  New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne K.","family":"Freitag","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Harvard Medical School  Boston MA USA"},{"name":"Ophthalmic Plastic Surgery Service Massachusetts Eye and Ear  Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael K.","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Harvard Medical School  Boston MA USA"},{"name":"Ophthalmic Plastic Surgery Service Massachusetts Eye and Ear  Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel R.","family":"Lefebvre","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Harvard Medical School  Boston MA USA"},{"name":"Ophthalmic Plastic Surgery Service Massachusetts Eye and Ear  Boston 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