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.
In this situation the risk of expulsion diminishes and it provides good volume with good motility. Author information Copyright and License information Disclaimer. Dermis-fat graft as a movable implant within the muscle cone.
Conclusion The most common indications for a dermis-fat graft were extrusion and large exposure. The mean preoperative CIFD was lower in anophthalmic subgroup Table 3 and the difference between the 2 subgroups was statistically significant. Orbital volume can be restored with the help of.
For the patients who underwent a dermis-fat graft but could not wear the eye prosthesis well because of a contracted anophtnalmic, we added a mucous-membrane graft to deepen the fornix. The drawback of our technique is that it should be performed under general anesthesia. View at Google Scholar D. How old is the current prosthetic and when was the last time it sockef polished?
Compared to the unaffected right eye, the left eye socket is socjet superiorly and the left lower eyelid is retracted. Noyes completed the first planned evisceration.
Indications and results in anophthalmic socket reconstruction using dermis-fat graft
A review of management. A short history of enucleation. The skin graft is harvested from the inner side of the arm, in an area without hair and the conformer is enveloped, placing the epidermis in in contact with the conformer.
Figure B shows an exposed, porous implant. Psychogenic factors, such as drug-seeking behavior, can also lead to pain, but these are diagnoses of exclusion. Explore our health library for more information about conditions and treatments. Does the patient have pain with the prosthetic in? Fascia lata technique is a new alternative and effective procedure to deepen the shallow inferior fornix that can be used in moderate to severe contracted sockets or anophthalmic socket syndrome with minimal lower eyelid or socket complications.
The commonest 13 cases clinical presentation to indicate the dermis-fat graft was an exposed implant mean width of 7. Autologous dermis graft at the time of evisceration or enucleation.
The Anophthalmic Socket – Reconstruction Options
The most common indications for a dermis-fat graft were extrusion and large exposure. Also fascia lata technique is not anohthalmic temporary procedure and so the desired pulling down tension on the lower lid retractors is expected to be maintained for long time as the nonelastic fascia is now fixed to the tough nonresilient periosteum. These implants are integrated with the orbit soft tissue, and, therefore, the defect can often be repaired leaving the implant in place.
The median duration between the date of visit and the date of secondary dermis-fat graft surgery was 7. National Center for Biotechnology InformationU. The lip was retracted with two towel clamps and incised with a number blade. Invented by Professor R. What do we do? The patient loses binocular vision with reduced visual field but suffers also changes in the perception of self that can lead to anxiety and depression.
The Anophthalmic Socket – Reconstruction Options
When dealing with an anophthalmic socket, the surgeon can help patients by restoring the volume lost by removing the eyeball and by restoring orbital architecture. 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. A prospective controlled study in which 24 sockets of 24 patients who were unable to wear and retain their ocular prosthesis due to shallow inferior fornix were enrolled and categorized into anophthalmic socket syndromes 9 patients and contracted sockets 15 patients.
The lateral incision was at the level of lateral canthus, the oscket one was at the level of the lower punctum, and the middle one was in between Figure 2. In the Lateral Cutaneous Incision. Regarding the success rate, there was no significant statistical difference in both anophthalmic and contracted socket subgroups. Current trends in managing the anophthalmic socket after primary enucleation and evisceration.
Once any socket problems have been corrected the ptosis can be addressed. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Discharge samples from four infected exposure-related implants were sent for culture. Our Locations Visit one of our convenient patient care locations.
Upper eyelid ptosis is common in the anophthalmic socket.
Obliterated or shallow lower fornix might occur either in contracted socket with conjunctival scarring and foreshortening or in anophthalmic socket or postenucleation socket syndrome where there is abundant conjunctiva with lacked inferior fornix fixation [ 1 ]. Our study comprised 23 males and 18 females, with a mean age of The implant can also be placed within the muscle cone, behind the scleral bag. 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.
A transconjunctival inferior fornix fixation is another method of repair of shallow inferior fornix in anophthalmic socket syndrome where the edges of the conjunctival incision are directly sutured to the periosteum with no need for externalized sutures and stents [ 5 ].