[Anophthalmos--a conjunctival implant].
The authors submit information on the completed development of a conjunctival implant and its use for modelling of the conjunctival sac in inborn and acquired anophthalmos. Plastic solution in inborn types is used for cosmetic reasons in unilateral degenerative and consecutive anophthalmos. The orbit and adnexa are usually only little affected. The other indication is secondary anophthalmos after enucleation of the bulbus when the conjunctival sac is threatened by retraction due to actionotherapy of the orbital area or a scarry process after a previous injury. The implant is a convex concave circular-shaped plate with a diameter of 20 mm the centre of which is thinner to facilitate manipulation during insertion. It is made from silicone rubber which has properties characterized as implant grade. Before the implantation proper the plate is adjusted by cutting to the desired size. The surgical procedure proper in inborn anophthalmos involves external canthotomy with gradual preparation of the conjunctiva into the Tenon space in the region of the eyelids to create a broad crevice into which the adjusted implant can be inserted. The operation is completed by closing the canthotomy supplemented by partial tarsorrhaphy using unabsorbable suture. Thus the implant is sufficiently fixed in the newly created ocular space. The silicone inlay is left for 3-6 months to allow epithelization of the surgical site round the implant. In acquired anophthalmos with retraction of the conjunctival sac in the first stage the lower transitory fold is released before insertion of the implant by the cul-de-sac method. The function of the implant is modelling of the conjunctival space in anophthalmos to maintain an adequate space for fornices for later insertion of the permanent prosthesis. The implant is manufactured at present by ELLA-CS.
Krásný
J
J
Ocní klinika FN Královské Vinohrady a 3. LF UK, Praha.
Novák
V
V
D000853:Anophthalmos / Q000601:surgery*; D002675:Child, Preschool; D003228:Conjunctiva / Q000601:surgery*; D005137:Eye, Artificial; D006801:Humans; D007223:Infant; D008297:Male; D019736:Prostheses and Implants