Orbital and Adnexal Service, Università Campus Bio-Medico Orbital and Adnexal Service, Villa Tiberia Hospital, Roma, Italy.
Curr Opin Ophthalmol. 2011 Sep;22(5):380-4. doi: 10.1097/ICU.0b013e328349948a.
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.
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.
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.
水凝胶义眼窝和眼眶扩张器的引入改变了先天性无眼症的康复方法。本研究基于个人经验和对近期文献的回顾，强调了先天性无眼症治疗的最新进展。
水凝胶义眼窝扩张器可在门诊局部麻醉下使用氰基丙烯酸酯胶进行定位，而不是进行临时睑板缝合。先天性无眼症儿童在早期真皮脂肪移植后，通过计算机断层扫描（CT）或磁共振成像（MRI）确认眶容积增加。一种由可充气硅橡胶球和钛 T 型板组成的眶组织扩张器，滑动安装在钛 T 型板上，并固定在眶外侧缘，似乎能有效刺激眶骨生长和发育。
先天性无眼症的病因复杂，涉及遗传和环境因素。理想的治疗方法是同时扩张眼睑、眼窝和眼眶骨，并且应该在出生后尽快开始。使用自膨胀扩张器进行眼窝扩张是一种有用的技术，尽管定制的塑形器可能会产生类似的效果。真皮脂肪移植也是一种合理的眶内植入物选择，前提是充分扩张眼睑和眼窝。
