The purpose of this article is to describe the different reconstruction techniques for anophthalmic sockets. In preparing the anopthalmic socket for prosthesis. Enucleation and evisceration introduce the anophthalmic socket syndrome, which consists of enophthalmos due to orbital tissue shrinkage. Following enucleation or evisceration surgery, the anatomy and physiology of the orbit are changed. These changes affect not only the cosmetic appearance of.
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The palpebral conjunctiva was injected by a 1: Indexed in Science Citation Index Expanded.
Indications and results in anophthalmic socket reconstruction using dermis-fat graft
After that he underwent the secondary dermis-fat graft. If the etiology is not clear and persists after prosthetic polishing and lubrication, the patient may need a CT scan to aid in diagnosis. Skin sutures were removed after one week and temporary conformer after 3 weeks Figure 6 and then the patients wore their ocular prostheses Figure 7.
Orbital implants Once the eyeball removed, with care and minimizing the alterations to the orbital content, attention is anophthzlmic on restoring the orbit volume. Nunnery WR, Cepela M.
The conformer can be biconvex, when orbital volume is diminished or convex-concave if the volume is acceptable but the conjunctival fornixes are retracted. The tissue over the anphthalmic should be examined for thinning, fistula or a defect.
How old is the current prosthetic and when was the last time it was polished? In the current study we used fascia lata strips to pull down anophtha,mic hold the lower eyelid retractors for deepening of the shallow inferior fornix in 24 cases. Successful procedure was considered if the patient could wear and retain the prosthesis in place comfortably in all soxket without lower eyelid entropion, ectropion, or retraction Figure 7.
On the other hand, a too small orbital implant will not anopythalmic lost volume leading to enophthalmos and deepening of the upper eyelid sulcus.
Besides the ptotic right upper eyelid, the patient has poor motility of the prosthesis. A review of management. Although this approach solves the patient’s health problem, by changes in physiognomy it can have a devastating effect on their perception and self-confidence. To evaluate a new surgical technique using fascia lata to deepen the shallow inferior conjunctival fornix in contracted socket and anophthalmic socket syndrome.
The dermis fat graft is harvested from the hip or groin area, in sovket area without hair that can be easily covered by a bathing suit and not located in a region of pressure. Author information Copyright and License information Disclaimer.
Therefore, a mucous membrane was added to deepen the fornix, and the size of the defect was measured. If the prosthesis is thick it may be placing pressure on the lower lid and could be camouflaging low orbital volume.
The Anophthalmic Socket – Reconstruction Options
Our oculoplastic surgeons anophthalic help determine if partial eye removal will be more beneficial, or if removing the entire eye is the only option.
Three of the 13 exposed implants underwent defect-closure intervention by means of an amniotic membrane graft two and tarsoconjunctival graft one before the secondary dermis-fat graft. The success rate of the dermis-fat graft alone was These implants are integrated with the orbit soft tissue, and, therefore, the defect can often be repaired leaving the implant in place. Clinico-pathologic study of 70 enucleations. In fascia lata technique, the conjunctiva was minimally manipulated in contrary to the long conjunctival incision and deep tissue dissection in conjunctival fixation procedure.
Contact Information View our phone directory or find a patient care location. The improvement in mean postoperative CIFD was higher in anophthalmic than in contracted subgroup Table 3 and the difference between the 2 subgroups was significant. anophthslmic
Journal of Ophthalmology
Both options require extraocular muscle integrity to ensure adequate motility. The domed dermis-fat graft orbital implant.
The anterior surface of the graft should have a diameter between anophthalmicc and 24 mm and a thickness of about 20 mm. Atrophy is greater if the socket has been traumatized, irradiated, infected or scarred.
Informed consents were obtained from all patients for the surgery 2. All of the patients became able to retain a prosthetic eye postoperatively with two patients having minimal postoperative lower anpohthalmic retraction and another two patients having minimal lower eyelid entropion but no secondary surgery was required.