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A Journal on Ophthalmology
Minerva Oftalmologica 2004 June;46(2):125-32
The early treatment of congenital anophthalmia with self-inflating hydrophilic orbital expanders
Sozzi D., Canzi G., Talatin C., Bozzetti A.
Congenital anophthalmia is a rare malformation due to the absence of the optic vesicle development. Therefore, there is a micro-orbitism, microblepharism and hemifacial hypoplasia. The authors report the early treatment of a patient affected by congenital unilateral anophthalmia who was treated at the Maxillo-facial Surgery Unit, S.Gerardo University Hospital of Monza, by self-inflating hydrogel orbital expanders implant. The procedure consisted in implanting, to a 7-month-old baby, a lens-shaped auto-expander with 9 ml of final volume for the expansion of the lids and to deepen the fornix. After 3 months, the first device has been replaced by a spherical expander with 2 ml of final volume and after 12 months by a 3 ml device for the orbital skeleton expansion, still in place, in association with an eye prosthesis already at 11 months of age. Today's follow-up is 30 months; clinical and ultrasound investigations have been regularly carried out in this period. Surgical procedure was very easy and quick. At the end of lids expansion period, the conjunctival sac and fornix were adequate to maintain both the spherical expander and the eye prosthesis. Palpebral rims are symmetrical. The use of spherical expanders together with eye prosthesis permitted to obtain a good facial skeleton symmetry with an excellent esthetic result. Contrary to the orbital expansive techniques requiring the use of silicon balls expanders or conformers, self-inflating hydrogel expanders are more comfortable for patients and require a less number of interventions.