Prosthetic motility in pegged versus unpegged integrated porous orbital implants

Purpose. To objectively measure and compare prosthetic motility in pegged versus unpegged orbital implants and to determine subjective patient assessment of motility after the pegging procedure. Methods: A prospective case series of 10 patients with integrated porous orbital implants, who had secondary motility peg placement procedure, were studied. Infrared oculography was used to quantitatively assess pegged and unpegged prosthetic eye motility in horizontal and vertical excursions. Results: For horizontal excursions, prosthetic motility in unpegged implants retained an average of 49.6% of measured motility of the contralateral normal eye, which increased to 86.5% with peg placement (P<0.05). For vertical excursions, prosthetic motility in unpegged implants retained an average of 51.3% of measured motility of the contralateral normal eye, which increased to 54.3% with peg placement (P<0.3). Nine of 10 patients judged their motility as "significantly improved," and I patient gave a rating of "some improvement" after peg placement. Four of 10 patients had granulomas around the peg sites. Conclusions. Objective assessment of prosthetic motility shows a significant increase in horizontal gaze after motility peg placement.