Expansion of the congenital anophthalmic socket by means of hydrophilic expanders
A. Bacskulin1, M. Vogel2, K.G. Wiese3, K. Gundlach4, R. Guthoff1
Purpose: In cases of congenital anophthalmia there is no eyeball acting as a stimulus for the development of the orbital structures. The treatment aims at fitting a serial prosthesis following enlargement of the conjuctival fornices and palpebral fissures. Additionally, various surgical procedures can be carried out for orbital expansion.
Material: During the past 15 months three children with bilateral or unilateral anoph- thalmia, age 4 to 11 months, were treated by implantation of a dehydrated highly hydrophilic poly-HEMA orbita expander into the small socket. Expander hydration of up to 98% was facilitated by uptake of tears and topical lubricants. After contineous expansion of the contracted fornices for at least 6 weeks, a first prosthesis was applied, followed by a painted ocular prosthesis as soon as possible.
Results: During the follow-up period of 6 to 15 months a significant dilatation of the socket was induced, allowing successful fitting of a hard conformer. Remarkable expansion of the horizontal eyelid length and reduction of entropion was achieved in all cases. No significant complication had occurred in this series.
Conclusion: Highly hydrophilic orbita expander induces rapid enlargement of the contracted anophthalmic sockets and symmetrization of palpebral fissures and aperture as compared with the normal side. This technique allows optimal fitting of an ocular prosthesis and results in a remarkable cosmetic improvement.
1Department of Ophthalmology, University of Rostock, Doberaner Str. 140, D-18057 Rostock
2Department of Ophthalmology, University of Göttingen, Robert-Koch-Str. 40, D-37075 Göttingen
3Department of Maxillo-Facial Surgery, University of Göttingen, Robert-Koch-Str. 40, D-37075 Göttingen
4Department of Maxillo-Facial Surgery, Strempelstr. 13, D-18055 Rostock