Evaluation of an integrated orbital tissue expander in congenital anophthalmos: report of preliminary clinical experience.

Abstract

PURPOSE:

To evaluate the effectiveness of an orbital tissue expander designed to stimulate orbital bone growth in an anophthalmic socket.

DESIGN:

Retrospective, noncomparative, interventional case series.

METHODS:

SETTINGS:

Institutional.

STUDY POPULATION:

Nine consecutive patients with unilateral congenital anophthalmos.

INTERVENTION:

The orbital tissue expander is made of an inflatable silicone globe sliding on a titanium T-plate secured to the lateral orbital rim with screws. The globe is inflated by a transconjunctival injection of normal saline through a 30-gauge needle to a final volume of approximately 5 cm(3). Computed tomography scans were used to determine the orbital volume. The data studied were: demographics, prior orbital expansion procedures, secondary interventions, orbital symmetry, and implant-related complications.

MAIN OUTCOME MEASURES:

The primary outcome measure was the orbital volume change, and the secondary outcome measures were changes in forehead, brow, and zygomatic eminence contour and adverse events.

RESULTS:

The average patient age at implantation was 41.89 ± 39.42 months (range, 9 to 108 months). The initial average volume of inflation was 3.00 ± 0.87 cm(3) (range, 2.0 to 4.0 cm(3)), and the average final volume of 4.33 ± 0.50 cm(3) (range, 4.0 to 5.0 cm(3)) was achieved. The duration of expansion was 18.89 ± 8.80 months (range, 4 to 26 months). All patients demonstrated an average increase in the orbital tissue expander implanted orbital volume of 5.112 ± 2.173 cm(3) (range, 2.81 to 10.38 cm(3)). The average difference between the volume of the implanted and the initial contralateral orbit was 5.68 ± 2.34 cm(3), which decreased to 2.53 ± 1.80 cm(3) at the final measurement (P < .001, paired t test). All implants remained inflated except for 2 iatrogenic punctures at the second inflation and 1 that was the result of implant failure. All were replaced.

CONCLUSIONS:

The integrated orbital tissue expander is safe and effective in stimulating anophthalmic socket bone growth.

• Authors: David T Tse, Mohammad Abdulhafez, Marcia A Orozco, Jeffrey D Tse, Amr Osama Azab, Leonard Pinchuk
• Journal: American journal of ophthalmology (Am J Ophthalmol) Vol. 151 Issue 3 Pg. 470-82.e1 (Mar 2011) ISSN: 1879-1891 [Electronic] United States
• PMID: 21145530 (Publication Type: Evaluation Study, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 Elsevier Inc. All rights reserved.

Topics

• Anophthalmos (diagnostic imaging, pathology, surgery)
• Bone Development
• Child
• Child, Preschool
• Female
• Humans
• Infant
• Male
• Orbit (diagnostic imaging, pathology, surgery)
• Orbital Implants
• Retrospective Studies
• Tissue Expansion (instrumentation, methods)
• Tissue Expansion Devices
• Tomography, X-Ray Computed