Integrated reconstructive strategies for treating the anophthalmic orbit.
BACKGROUND
Anophthalmia may be congenital or acquired. Congenital anophthalmia refers to any orbit that contains a severely hypoplastic eye at birth (microphthalmia), or a complete absence of the globe due to failure of optic vesicle formation. In both those cases the aim of surgery is to stimulate adequate orbital growth. Acquired anophthalmic orbit may be due to trauma or tumour. In acquired forms the goal is restoration of orbital volume with adequate replacement of orbital contents.


METHODS
In this study 28 patients (6 cases of congenital and 22 of acquired anophthalmia), were treated between October 1997 and August 2002, by applying protocols that are based on data from the literature.


RESULTS
In 19 cases there were satisfactory results. Complications such as implant dislocation (3 cases), residual asymmetry (2 cases), and eyelid retraction required revisional surgery (4 cases).


CONCLUSIONS
The different strategies applied for reconstructing the missing structures of the orbit in the congenital forms have given satisfactory results related to the type and complexity of the deformity. In rehabilitating a patient with an acquired anophthalmic orbit it is essential to ensure that the patient has realistic expectations regarding a final prosthesis. Interaction of the various healthcare professionals is also essential to help the patient and so develop new prosthetic devices as well as innovative methods for socket reconstruction.
Unit of Cranio-Maxillofacial Surgery, Centre of Orbital Pathology and Surgery, St.Anna Hospital and University, Ferrara, Italy. lclauser@pol.it
Luigi
L
Clauser
Elisabetta
E
Sarti
Vittorio
V
Dallera
Manlio
M
Galiè
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000853:Anophthalmos / Q000601:surgery*; D002648:Child; D002985:Clinical Protocols; D015353:Eye Enucleation / Q000534:rehabilitation; D005131:Eye Injuries / Q000601:surgery; D005134:Eye Neoplasms / Q000601:surgery; D005141:Eyelid Diseases / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008850:Microphthalmos / Q000601:surgery; D008875:Middle Aged; D009915:Orbit / Q000254:growth & development / Q000601:surgery*; D020273:Orbital Implants / Q000009:adverse effects; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011475:Prosthesis Failure; D019651:Plastic Surgery Procedures; D012086:Reoperation; D016896:Treatment Outcome