Abstract
Purpose: To evaluate our results in the management of socket contraction. Design: Case series Method: One hundred and eighty eight patients with contracted sockets were retrospectively analyzed. Reasons for eye removal, type of initial surgery, presence of an implant, time of onset of contraction, degree of contraction, additional pathologies accompanying contraction, type of surgery for the contracted socket, additional interventions, number of surgeries, and final status were recorded and evaluated. Results: There were 101 (53.72%) male and 87 (46.28%) female patients, with an age range between 1 and 78 years (mean 35.46 years). Mean follow-up was 45.6 ± 22.34 months (range 5-120 months). Trauma was the reason for eye removal in 80(42.55%) patients. Enucleation performed in 146(77.66%) patients was the most common initial surgery. An implant was absent in 143(76.06 %) patients. Time of onset of contraction was longer than 5 years in 56 (29.79%) patients. Moderate or severe contraction was recorded in 134(71.28%) patients. Totally 229 procedures were performed for socket surface expansion and 30.32% of patients required more than one surgery. 151(80.32%) patients had additional pathologies. At the final visit, 138 (73.4%) patients had a good or acceptable result. Conclusion: Contracted socket remains to be a challenging entity of oculoplastic surgery. It may develop at any time following removal of the eye. Additional pathologies frequently accompany the contracted socket. Even though wearing an artificial eye eventually becomes possible in the majority of cases, it is still hard for some patients even after a series of reconstructive interventions.
Highlights
IntroductionFitting an ocular prosthesis is mandotary in the management of anophthalmia
Anopthalmia leads to cosmetic deformity and may affect patients’ psychology [1]
Fitting an ocular prosthesis is mandotary in the management of anophthalmia
Summary
Fitting an ocular prosthesis is mandotary in the management of anophthalmia. Socket contraction is the main problem in the anopthalmic patients and characterized by scarring, granulation tissue formation and loss of fornices [2]. The aim of socket surgery is to form a socket which is able to carry an ocular prosthesis which simulates normal fellow eye [4,5]. To fit prosthesis, presence of adequate fornices and lining is mandatory. Socket contraction leads to fornix and lining deficiency (Figure 1). Many factors, including fibrosis due to initial trauma, poor surgical technique, multiple socket procedures, irradiation, alkali burns, cicatrizing disease of conjunctiva may be the reason of socket contraction [6]. In moderate or severe forms of socket contraction, it may be impossible to fit prosthesis (Figures 2-4) [7]
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