title: Adjunctive use of hyaluronic acid gel (Restylane Sub-Q) in anophthalmic volume deficient sockets and phthisical eyes.
abstract: OBJECTIVE
  This study aims to present the use of Restylane Sub-Q for orbital volume augmentation in patients with secondary volume deficiency either postenucleation or postevisceration or those with phthisical eyes.
  
  
  METHODS
  This prospective case series reviews clinical, photographic, and radiologic records of 16 patients with anophthalmic or enophthalmic orbits who underwent volume augmentation by injection with hyaluronic acid gel in the intraconal and extraconal posterior orbit. The technique is discussed in detail.
  
  
  RESULTS
  The volume of hyaluronic acid gel injected ranged from 2 to 4 ml (mean volume, 2.3 ml) per orbit, with a mean reduction of enophthalmos of 3.7 mm (71.4%) at 1 week, 2.8 mm (59.9%) at 6 months, and 2.5 (51.3%) at 12 months, with follow-up of 94.1%, 68.8%, and 50% of the patient group, respectively. Follow-up after 12 months consisted of subjective feedback from the patient. With the exception of one patient, the mean subjective follow-up period was 14.7 months (maximum, 22.4 months; minimum, 1.6 months). The procedure was well tolerated by 15 of the 16 patients who all experienced an improvement in cosmetic appearance. There was one possible complication of orbital cellulitis (although not examined by our clinic); this patient did not attend further follow-ups. One patient had full correction of her enophthalmos, which was maintained over 12 months.
  
  
  CONCLUSIONS
  Hyaluronic acid gel injections in patients with enophthalmic sockets appear to be a safe, tolerable, and minimally invasive alternative for orbital volume augmentation in the outpatient setting. However, as predicted, its affects are temporary, and volume does begin to decrease within 12 months of injection.
authors.affiliation: Ophthalmology Department, Western Eye Hospital, London, United Kingdom.
authors.forename: Maryam
authors.initials: M
authors.lastname: Zamani
authors.forename: Sri
authors.initials: S
authors.lastname: Thyagarajan
authors.forename: Jane M
authors.initials: JM
authors.lastname: Olver
mesh_terms: D003357:Cosmetic Techniques; D015841:Enophthalmos / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D015353:Eye Enucleation; D017234:Eye Evisceration; D005137:Eye, Artificial; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000000981:diagnostic imaging / Q000187:drug effects*; D020273:Orbital Implants; D011446:Prospective Studies; D015626:Tissue Expansion / Q000379:methods*; D014057:Tomography, X-Ray Computed
chemical_list: D006820:Hyaluronic Acid; C445361:Restylane