Combined oculoplastic operation for contracted conjunctival sac and depressed eye socket of anophthalmos

Abstract

Objective To explore combined oculoplastic surgery methods for treating narrow conjunctival sac and sunk socket after enucleation or evisceration. Methods Thirty-five cases with narrow conjunctival sac and sunk socket were treated with secondary hydroxyapatite or Medpor orbital implantation combined with plasty of the cul - de - sac. Seven cases with mild impairment were cut open the bottom or top of the conjunctival fomix, 23 patients with moderate impairment were repaired by preserved sclera conjunctival sac, 5 eases of severe conjunctival defect were repaired by autologous oral mucosa transplants. An eye substitute was put in the conjunctival sac in every case. In mild and moderate impairment groups temporary palpebral suture were done, the eyelids were opened lmonth after surgery. The superior and lower eyelids were closed with partial blepharorrhaphy in oral mucosa transplant groups and the eyelids were opened 3 months after surgery and a suitable prosthesis was implanted. We observed the rectified sunk socket, the shaping of conjunctival sac, the motion of prosthetic eyes and the implants exposure or infection. The follow-up was 3 to 6 months. Results All patients were satisfied with the correction of the stenosis of the cul - de - sac and sunk socket. The ocular prostheses were perfectly placed with a good degree of movement. Conclusions Provided requisite surgical skills are employed, secondary hydroxyapatite or Medpor orbital implantation combined with plasty of the cul - de - sac can effectively treat narrow conjunctival sac and sunk socket, as well as improve the aesthetic results and avoid serious postoperative complications. Key words: Combined oculoplastic operation; Sunk socket; Narrow conjunctival sac