Anophthalmic Patient Research Articles

Enucleation, evisceration, and exenteration.

This review outlines many of the recent advancements in the understanding and management of the anophthalmic patient. A population-based study demonstrated that the annual incidence of enucleations for all causes was about 3 to 5 per 100,000. Application of expandable orbital implants appears to be promising in the management of microphthalmia or anophthalmia in infants to maximize orbital growth. Some reports on the use of hydroxyapatite enucleation implants are encouraging, with no major complications observed in one large series. Yet other reports of hydroxyapatite implant exposures, at a very concerning frequency, are also beginning to emerge. Few of the exposures heal spontaneously; however, infections or extrusions are very rare, and they are attributable to the porous composition of the implant. Conjunctival flaps alone are suboptimal in the management of exposures. Adjunctive autologous fascial grafts seem preferable to heterologous sclera in the management of these exposures. Magnetic resonance imaging of the hydroxyapatite implant appears to be superior to bone scan in the noninvasive assessment of vascularization of these implants. Further advancements are necessary to achieve a more optimal enucleation implant.

Anophthalmia in the Focal Dermal Hypoplasia Syndrome

We examined an orbital exenteration specimen from an anophthalmic patient with focal dermal hypoplasia. Eyelid angiofibromas were evident and immunoperoxidase studies for human papilloma virus were negative. Orbital tissue contained a ductal cyst, chronic inflammation of the lacrimal duct and sac, rudimentary conjunctival fornices, lacrimal gland, striated muscle, and adipose tissue. Microscopic examination revealed a posteriorly located cystic structure with uveal and lens remnants. Neuroectodermal structures consistent with retina, optic nerve, or meninges were not observed, thus representing true anophthalmia. These findings remain as the only histopathologic description of ocular tissues in patients with focal dermal hypoplasia.

The Anophthalmic Socket

Following enucleation or evisceration surgery, the anatomy and physiology of the orbit are changed. These changes affect not only the cosmetic appearance of the anophthalmic patient but also the function of the socket and the prosthesis. Surgical techniques for primary enucleation and evisceration surgery and correction of early and late complications are described. During the course of this century many operations and prosthetic devices have been advocated. A brief summary of these is given as well as detailed surgical descriptions of techniques the author believes have proven successful over the years.

News and Comment

<h3>Calendar of Events</h3> <h3>New Jersey Academy Meeting.</h3> —The annual fall meeting of the New Jersey Academy of Ophthalmology and Otolaryngology will be held on Nov 12,1975, at the Robert Treat Hotel in Newark. The morning session will be devoted to a Cataract Symposium, and a Corneal Symposium will be given in the afternoon. For further information, please contact Marshall S. Klein, Executive Secretary, Eye Institute of New Jersey, 15 S Ninth St, Newark, NJ 07107. <h3>American Society of Ocularists 18th Annual Meeting.</h3> —On Sept 20, 1975, the American Society of Ocularists will hold its 18th annual meeting in Dallas. The scope of the meeting will integrate basic and fundamental definitions, concepts, and techniques with the clinical management of the anophthalmic patient. For advance registration, contact Pierre Guibor, MD, and Marsha Guibor, 200 E 66th St, Suite B-1801, New York, NY 10021. <h3>Appointed Chairman of Department.</h3> —Dr. Peter Y. Evans has