Integrated reconstructive strategies for treating the anophthalmic orbit

Introduction: 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. Patients and 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. (C) 2004 European Association for Cranio-Maxillofacial Surgery.