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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Exenteration, partial or total, has completely different reconstruction techniques that will not be addressed in this article. Exposed porous orbital implants treated with simultaneous secondary implant and dermis fat graft.
Indexed in Science Citation Index Expanded. The commonly performed tarsal strip procedure soket correct the laxity; less commonly, lower eyelid sling procedures are at times used. These sutures may be removed in weeks after adequate fibrosis has occurred between the inferior fornix and periosteum. Abstract Objectives To present the indications for a dermis-fat graft in anophthalmic socket reconstruction and evaluate the results of this procedure.
In Ophthalmic Plastic Surgery, 4th Ed. Discharge samples from four infected exposure-related implants were sent for culture.
Anophthalmic Socket | Oculoplastic Surgery at Wilmer Eye Institute
On the other hand, a too small orbital implant will not restore lost volume leading to enophthalmos and deepening of the upper eyelid sulcus. This is a retrospective interventional case series containing data collected between August 1, and July 31, We preferred to perform a dermis-fat graft for implant extrusion because the average length of time before the secondary dermis-fat graft could be performed was 7.
The three main surgical techniques for partial or complete eye removal are:. Predicting the ideal implant size beforeenucleation. After that he underwent the secondary dermis-fat graft. Tarsal patch-flap for orbital implant exposure. 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 drawback of our technique is that it should be performed under general anesthesia.
The methyl methacrylate sphere is part of the non-porous orbital implants and is most commonly used to restore volume lost after evisceration. Published online May 4. In this case the implant is placed in the scleral bag, anophthamic adequate good volume and motility.
Evaluation of the Anophthalmic Socket
This process is physiological, but can be accelerated if the graft is injured or poorly vascularized. Then we dissected and lysed the scar to create space, especially in the inferior fornix.
Perspective on orbital enucleation implants. The upper eyelid position should be noted for ptosis, and levator function should be evaluated. Dermis-fat graft for treatment of exposed porous anophthalmid implants in pediatric postenucleation retinoblastoma patients. Management of exposed hydroxyapatite orbital implant. This can be a true ptosis or a pseudoptosis due to poor support from the prosthetic or poor orbital volume and implant location.
In the Lateral Cutaneous Incision. Find a Job Post a Job. For the anophthxlmic who underwent a dermis-fat graft but could not wear the eye prosthesis well because of a contracted socket, we added a mucous-membrane graft to deepen the fornix. Free orbital fat graft to prevent porous polyethylene orbital implant exposure in patients with retinoblastoma. After that he underwent the dermis-fat graft with anophtalmic tarsal strip procedure when he was 3 years old.
Dermis-fat graft as a movable implant within the muscle cone. Health Library Explore our health library for more information about conditions and treatments. Visit one of our convenient patient care locations. Management of the shallow or obliterated lower fornix usually is directed towards the underlying aetiology.
Journal of Ophthalmology
Primary dermis-fat grafting in children. The ideal implant restores most of the volume, leaving enough space for the prosthesis. The dermis-fat graft was then placed in the prepared socket; a single interrupted 6—0 polyglactin suture was performed between the dermis-fat graft and the conjunctiva—Tenon complex. A Before the eye prosthesis wearing, a year-old male who underwent evisceration with nonporous implant. The palpebral conjunctiva was injected by a 1: We included patients who underwent either primary or secondary dermis-fat grafts for the first time.