title: Congenital anophthalmia: current concepts in management.
abstract: OBJECTIVE
  The introduction of hydrogel socket and orbital expanders has modified the approach towards the rehabilitation of congenital anophthalmia. This study highlights the most recent advances for the treatment of congenital anophthalmia based on personal experience and the review of recent literature.
  
  
  RESULTS
  Hydrogel socket expanders may be positioned as an out-patient procedure with topical anaesthesia, using cyanoacrylate glue as opposed to temporary tarsorraphy. Increased orbital volume has been confirmed by computed tomography (CT) scan or magnetic resonance imaging (MRI) following early dermis-fat graft in children with congenital anophthalmia. An orbital tissue expander made of an inflatable silicone globe sliding on a titanium T-plate and secured to the lateral orbital rim appears to be effective to stimulate orbital bone growth and development.
  
  
  CONCLUSIONS
  Congenital anophthalmia has a complex cause with both genetic and environmental factors involved. The ideal treatment is simultaneous expansion of the eyelids, socket and orbital bones, and it should begin after birth as soon as possible. Socket expansion with self-inflating expanders is a useful technique, although custom-made conformers may produce similar results. Dermis-fat grafts are another reasonable option as an orbital implant, following adequate lid and socket expansion.
authors: Orbital and Adnexal Service, Università Campus Bio-Medico Orbital and Adnexal Service, Villa Tiberia Hospital, Roma, Italy. frquar@tin.it
authors: Francesco M
authors: FM
authors: Quaranta-Leoni
mesh_terms: D000853:Anophthalmos / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery*; D002675:Child, Preschool; D005137:Eye, Artificial; D005143:Eyelids / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009915:Orbit / Q000503:physiopathology / Q000601:surgery*; D020273:Orbital Implants; D010045:Outpatients; D013524:Surgical Flaps; D015626:Tissue Expansion / Q000379:methods*; D015625:Tissue Expansion Devices
chemical_list: D020136:Hydrogel, Polyethylene Glycol Dimethacrylate