The Anophthalmic Socket - Reconstruction Options

Abstract

Keeping the eye is impossible, functionality is lost and aesthetic requirements are high. What do we do? Which approach is right? This is the dilemma we face whenenucleation or evisceration are unavoidable. The patient loses a sensory organ with a very important function and, at the same time, is faced with a major aesthetic defect, leading to significant anxiety. The purpose of this article is to describe the different reconstruction techniques for anophthalmic sockets. In preparing the anopthalmic socket for prosthesis fitting we have several options: dermis-fat graft with a very good biocompatibility, the Guthoff artificial implant, which provides better motility or the methyl methacrylate implant inside the muscle cone. Each option has advantages and disadvantages but the choice of technique should be adapted to the needs and expectations of the patient, taking into account both time and cost.

Keywords: anophthalmia; reconstruction.

Fig. 1a

Evisceration with methylmetacrylate sphere

Fig. 1b

Methylmetacrylate sphere and prosthesis

Fig. 2

Serous cyst between Tenon’s capsule and conjunctiva

Fig. 3a

Methylmetacrylate sphere placed within the muscle cone

Fig. 3b

Methylmetacrylate sphere in the muscle cone and prosthesis

Fig. 4

Methylmetacrylate implant wrapped in mesh

Fig. 5

Hydroxyapatite implant

Fig. 6

Guthoff implant

Fig. 7

Guthoff implant - surgery

Fig. 8

the dermis fat graft

Fig. 9a

The dermis fat graft – 3 days after surgery

Fig. 9b

The dermis fat graft and prosthesis ( left eye)

Fig. 10

Conformer enveloped in skin graft, hyaluronic acid lower sulcus