title: Expansion of the socket and orbit for congenital clinical anophthalmia.
abstract: BACKGROUND
  Congenital clinical anophthalmia requires fitting an artificial eye, achieving a pleasing aspect of the palpebral apparatus, and stimulating growth of the orbit, as well as of the entire midface.
  
  
  METHODS
  Out of 25 patients with clinical anophthalmia, 22 were treated according to a new protocol (first described by Wiese et al. in 1999) and followed for up to 6 years. In 10 patients, anophthalmia was bilateral, in nine patients, it was on the right side only and in three it was on the left side only. Treatment consisted of implantation of an osmotic expander to first stimulate growth of the conjunctival sac and eyelids followed by serial implantation of osmotic expanders to stimulate growth of the orbit (and thus of the midface). The material used was a copolymer of methylmethacrylate and N-vinylpyrrolidone.
  
  
  RESULTS
  Fitting of an artificial eye was without any problem within the first year of life for the most part. Growth of the orbit was stimulated by more than 65 percent of a healthy one. Aesthetically, the results were very largely pleasing. Complications were encountered, especially when the wrong expander sizes had been implanted.
  
  
  CONCLUSIONS
  Using osmotic expanders of this type, through a staged therapy of minor operations, promises to achieve all goals before the child enters school.
authors.affiliation: Department of Cranio Maxillofacial Surgery, University Hospitals, Rostock, Germany.
authors.forename: Karsten Kurt Helmuth
authors.initials: KK
authors.lastname: Gundlach
authors.forename: Rudolf Friedrich
authors.initials: RF
authors.lastname: Guthoff
authors.forename: Volker Hermann Martin
authors.initials: VH
authors.lastname: Hingst
authors.forename: Michael Peter
authors.initials: MP
authors.lastname: Schittkowski
authors.forename: Ulrich Christian
authors.initials: UC
authors.lastname: Bier
mesh_terms: D000015:Abnormalities, Multiple; D000853:Anophthalmos / Q000601:surgery*; D002675:Child, Preschool; D002985:Clinical Protocols; D005137:Eye, Artificial; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008768:Methylmethacrylates / Q000627:therapeutic use*; D009915:Orbit / Q000254:growth & development; D011205:Povidone / Q000627:therapeutic use*; D019651:Plastic Surgery Procedures / Q000379:methods*; D015625:Tissue Expansion Devices
chemical_list: D008768:Methylmethacrylates; C037334:poly(methylmethacrylate-N-vinylpyrrolidone); D011205:Povidone