Alanazi Reem R, Schellini Silvana A, Alhussain Hailah, Elkhamary Sahar, Khandekar Rajiv, AlSheikh Osama
Oculoplastic Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Department of Ophthalmology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Orbit. 2022 Dec;41(6):691-699. doi: 10.1080/01676830.2021.1990350. Epub 2021 Oct 28.
To evaluate the outcomes of orbital hydrogel expanders in the management of congenital anophthalmia.
In this retrospective one-armed cohort study, a chart review was performed of eight children with congenital anophthalmia who underwent orbital expansion using orbital hydrogel tissue expander from January 2006 to July 2018. Computed tomography (CT) of orbital parameters was evaluated before and after surgery. Changes in the orbital parameters were correlated with clinical factors.
The study sample comprised 11 anophthalmic orbits of eight children (seven males, one female; median age = 12 months), with a median postoperative follow-up of 3.8 years. The anophthalmic orbital parameters after hydrogel expander implantation improved significantly compared to preoperative assessment as follows: mean orbital height improved from 21.7 mm to 25.4 mm ( < .001); width from 19.2 mm to 23.8 mm ( < .001); depth from 27.5 mm to 32.6 mm ( = .008); and volume from 3.7 cm to 5.3 cm ( = .001). Despite enlargement in all dimensions, the anophthalmic orbits with hydrogel expander had a significantly lower development than the normal orbits, mainly in height and volume. At the last postoperative visit, four (36.4%) cases had fornices deep enough to maintain the conformer. Migration and extrusion occurred in two (18.2%) cases.
Orbital hydrogel expander can improve the orbital development in congenital anophthalmia. However, the enlargement is not as extensive as that observed in the normal orbit. Orbital expanders associated with external conformers were not sufficient to induce normal growth of lids and fornix.
评估眼眶水凝胶扩张器在先天性无眼球治疗中的效果。
在这项回顾性单臂队列研究中，对2006年1月至2018年7月期间使用眼眶水凝胶组织扩张器进行眼眶扩张的8例先天性无眼球患儿进行了病历回顾。对手术前后的眼眶参数进行计算机断层扫描（CT）评估。眼眶参数的变化与临床因素相关。
研究样本包括8例患儿的11个无眼球眼眶（7例男性，1例女性；中位年龄 = 12个月），术后中位随访时间为3.8年。与术前评估相比，水凝胶扩张器植入后无眼球眼眶参数有显著改善，如下：平均眼眶高度从21.7 mm提高到25.4 mm（P <.001）；宽度从19.2 mm提高到23.8 mm（P <.001）；深度从27.5 mm提高到32.6 mm（P =.008）；体积从3.7 cm³提高到5.3 cm³（P =.001）。尽管各维度均有增大，但有水凝胶扩张器的无眼球眼眶发育明显低于正常眼眶，主要在高度和体积方面。在最后一次术后随访时，4例（36.4%）病例的穹窿足够深以维持塑形器。2例（18.2%）病例发生了移位和挤出。
眼眶水凝胶扩张器可改善先天性无眼球的眼眶发育。然而，其增大程度不如正常眼眶明显。与外部塑形器相关的眼眶扩张器不足以诱导眼睑和穹窿的正常生长。
