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Evaluation of an integrated orbital tissue expander in congenital anophthalmos: report of preliminary clinical experience.

Abstract：

PURPOSE:To evaluate the effectiveness of an orbital tissue expander designed to stimulate orbital bone growth in an anophthalmic socket. DESIGN:Retrospective, noncomparative, interventional case series. METHODS: SETTINGS:Institutional. STUDY POPULATION:Nine consecutive patients with unilateral congenital anophthalmos. INTERVENTION:The orbital tissue expander is made of an inflatable silicone globe sliding on a titanium T-plate secured to the lateral orbital rim with screws. The globe is inflated by a transconjunctival injection of normal saline through a 30-gauge needle to a final volume of approximately 5 cm(3). Computed tomography scans were used to determine the orbital volume. The data studied were: demographics, prior orbital expansion procedures, secondary interventions, orbital symmetry, and implant-related complications. MAIN OUTCOME MEASURES:The primary outcome measure was the orbital volume change, and the secondary outcome measures were changes in forehead, brow, and zygomatic eminence contour and adverse events. RESULTS:The average patient age at implantation was 41.89 ± 39.42 months (range, 9 to 108 months). The initial average volume of inflation was 3.00 ± 0.87 cm(3) (range, 2.0 to 4.0 cm(3)), and the average final volume of 4.33 ± 0.50 cm(3) (range, 4.0 to 5.0 cm(3)) was achieved. The duration of expansion was 18.89 ± 8.80 months (range, 4 to 26 months). All patients demonstrated an average increase in the orbital tissue expander implanted orbital volume of 5.112 ± 2.173 cm(3) (range, 2.81 to 10.38 cm(3)). The average difference between the volume of the implanted and the initial contralateral orbit was 5.68 ± 2.34 cm(3), which decreased to 2.53 ± 1.80 cm(3) at the final measurement (P < .001, paired t test). All implants remained inflated except for 2 iatrogenic punctures at the second inflation and 1 that was the result of implant failure. All were replaced. CONCLUSIONS:The integrated orbital tissue expander is safe and effective in stimulating anophthalmic socket bone growth.

journal_name

Am J Ophthalmol

journal_title

American journal of ophthalmology

authors

Tse DT,Abdulhafez M,Orozco MA,Tse JD,Azab AO,Pinchuk L

doi

10.1016/j.ajo.2010.09.009

subject

Has Abstract

pub_date

2011-03-01 00:00:00

pages

470-82.e1

issue

eissn

0002-9394

issn

1879-1891

pii

S0002-9394(10)00684-7

journal_volume

151

pub_type

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Evaluation of an integrated orbital tissue expander in congenital anophthalmos: report of preliminary clinical experience.