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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Therefore, a mucous membrane was added to deepen the fornix, and the size of the defect was measured.
Other conditions that may cause discharge are poor prosthetic fit, extruding implant See Figures 3a and bpyogenic granuloma in the socket, excessively deep fornices or nasolacrimal duct obstruction. We included patients who underwent either primary or secondary dermis-fat grafts for the first time. Central depth of the inferior fornix was measured preoperatively and postoperatively. View our phone directory or find a patient care location.
Ophthal Plast Reconstr Surg. It is divided into two areas; the posterior half is methyl methacrylate and anterior half of hydroxyapatite, where there are anophhhalmic grooves for suturing the extraocular muscles Fig. Open in a separate window. Levator function in the evaluation and management of blepharoptosis.
Indications and results in anophthalmic socket reconstruction using dermis-fat graft
The later occurs possibly as there is no globe and so the inferior rectus muscle is at a higher level in the socket with subsequent anophthalmif of the annophthalmic lid retractors and their connections including the fornical conjunctiva [ 3 ]. In this case the prosthesis should be larger but this cause discomfort and reduced motility. Does the patient have polycarbonate glasses to protect the seeing eye?
In spite of the above good results of the conjunctival fixation technique, it seems that the fascia lata technique is superior for the following reasons: This article has been cited by other articles in PMC.
Unfortunately, both techniques have disadvantages. A review of management. Management of exposed hydroxyapatite orbital implant. In anophthalmic socket syndrome as there is no globe the inferior orbital fat migrated anteriorly and also the inferior rectus muscle is at a higher level in the socket with subsequent elevation of the lower lid retractors and their connections including the fornical conjunctiva.
The depth of the inferior conjunctival fornix was measured in mm at the center of the lower eyelid in all participants in the control group and in patient subgroups. The autogenous dermis-fat orbital implant in children. In our practice we found that it is more efficient in the long term to perform duplicationof conjunctiva and Tenon’s capsule and to suturein two layers. The commonest 13 cases clinical presentation to indicate the dermis-fat graft was an exposed implant mean width of 7.
Ophthal Plast Reconstr Surg. Anophthalmia with exposed implant, OD. Another 24 patients who underwent evisceration or enucleation with healthy sockets and can wear and retain their prosthesis comfortably were chosen as a control group. Another considerable advantage at anophhhalmic time was that hydroxyapatite implant allows placing a peg that connects to the prosthesis, offering a very good motility.
The fascia lata technique is a new, alternative, and effective procedure to correct the shallow inferior fornix in anophthalmic socket syndrome where minimal socket dissection is required and complications of the deepening sutures are to be avoided also in moderate to severe contracted sockets fascia lata technique which is a second alternative to deepening sutures but avoids their complications.
Current trends in managing the anophthalmic socket after primary enucleation and evisceration. In these cases, a silastic stent e.
Journal of Ophthalmology
Inthe dermis-fat graft for anophthalmic socket reconstruction was introduced by Smith et al. Contact Information View our phone directory or find a patient care location. Depicting indications for evisceration and enucleation in patient group. Patient with anophthalmic wocket syndrome having shallow inferior fornix and lax lower eyelid.
This is a retrospective interventional case series containing slcket collected between August 1, and July 31, Regardless of the implant used and the surgical technique, the goals of the surgeon remain the same; treating the underlying condition, replacing orbital volume, maximizing motility and providing the most comfortable and aesthetically symmetric appearance. Methyl methacrylate sphere The methyl methacrylate sphere is part of the non-porous orbital implants and is most commonly used to restore volume lost after evisceration.
The upper eyelid sulcus deepening and enophthalmos were more common in patients whose orbital volume replacement implant and prosthesis was smaller than the volume of the healthy eyeball.
The Anophthalmic Socket – Reconstruction Options
Whether you’re crossing the country or the anophthlmic, we make it easy to access world-class care at Johns Hopkins. Search the Health Library Get the facts on diseases, conditions, tests and procedures. A statistically significant improvement of the postoperative central inferior fornix depth was reported which was marked in anophthalmic subgroup.
Perspective on orbital enucleation implants. These sutures may be removed in weeks after sockeh fibrosis has occurred between the inferior fornix and periosteum. Dermis-fat graft as a movable implant within the muscle cone. The graft was sutured into the anophhalmic of the fornix using interrupted and anopnthalmic 6—0 polyglactin sutures.
Exposed porous orbital implants treated with simultaneous secondary implant and dermis fat graft. On the other hand, a too small orbital implant will not restore lost volume leading to enophthalmos and deepening of the upper eyelid sulcus.
Depicting demographic data and preoperative CIFD of control and patient groups.
If the ptosis is mild the ocularist can build up the prosthetic superiorly to support the upper eyelid. A horizontal inferior fornical incision was performed and minimal dissection was done with excision of the fibrous bands if any to prepare the bed for the mucosal graft.