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Acta Ophthalmologica May 2018Secondary orbital implantation surgery can be complex due to scarring of the orbital tissues and can be complicated by implant exposure and extrusion.
BACKGROUND
Secondary orbital implantation surgery can be complex due to scarring of the orbital tissues and can be complicated by implant exposure and extrusion.
PURPOSE
To evaluate the incidence and risk factors of implant exposure and extrusion following secondary alloplastic orbital implantation surgery in anophthalmic patients.
METHODS
Retrospective analysis of a consecutive series of patients who underwent secondary placement of an alloplastic orbital implant by one surgeon between 2001 and 2016 in the Rotterdam Eye Hospital.
OUTCOME PARAMETERS
implant exposure or extrusion. Other complications.
RESULTS
Sixty-three patients underwent secondary orbital placement of scleral-wrapped acrylic (60) or silicone (three) spherical implants. A subset of 25 patients had undergone earlier secondary orbital implant placement (by other surgeons) with exposure/extrusion necessitating additional implant surgery. Two patients were excluded due to lack of follow-up (<3 months). Mean age was 49 years (range: 1-84.5 years). The mean follow-up was 4.1 years (range: 0.25-13, 6 years). Implant exposure or extrusion occurred in six of 18 (33%) patients in whom no muscle had been reattached during secondary orbital implantation and in five of 43 (12%) patients in whom the extraocular recti muscles had been attached, but the follow-up time was shorter for the latter group. Surgical treatment for implant exposure/extrusion was required in eleven of 61 patients (18%). Other complications included postoperative volume deficiency despite optimal prosthesis (five of 61, 8%), inclusion cysts (four of 61, 7%) and conjunctivitis sicca (two of 61, 3%). Seven of 61 (11%) patients required fornix deepening and seven (11%) blepharoptosis correction.
CONCLUSION
Secondary orbital implantation of sclera-wrapped alloplastic implants was complicated by implant extrusion or exposure in 12% of cases in which the extraocular muscles were attached to the implant.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anophthalmos; Child; Child, Preschool; Coated Materials, Biocompatible; Eye Evisceration; Female; Follow-Up Studies; Foreign-Body Migration; Humans; Incidence; Infant; Male; Middle Aged; Netherlands; Orbital Implants; Polymethyl Methacrylate; Postoperative Complications; Reoperation; Retrospective Studies; Sclera; Young Adult
PubMed: 29220117
DOI: 10.1111/aos.13611 -
Clinical & Experimental Optometry Jul 2013The aim of this study was to investigate the inflammatory response of the anophthalmic socket to prosthetic eye wear.
PURPOSE
The aim of this study was to investigate the inflammatory response of the anophthalmic socket to prosthetic eye wear.
METHODS
One hundred and two prosthetic eye wearers were recruited for this observational study. Photographic grading scales were used to measure the severity of conjunctival inflammation and the extent and intensity of stained deposits on the prosthetic eyes. Tear volume was measured with the phenol red thread test. For mucoid discharge, visual analogue scales were used to assess frequency of occurrence, colour, volume and viscosity. For the prostheses, assessments were made of weight, shape, wearing time and frequency of cleaning.
RESULTS
Anophthalmic sockets had more severe conjunctival inflammation than their companion eyes (p = 0.0001). The difference in inflammation between the companion eye and the anophthalmic socket was associated with discharge volume (p = 0.01) and discharge viscosity (p = 0.007) with greater difference in inflammation being associated with higher levels of discharge volume and viscosity. A greater difference in inflammation was also associated with less surface deposition (p = 0.009). No evidence of associations was found between difference in conjunctival inflammation and the other variables.
CONCLUSIONS
Recently developed grading scales for measuring inflammation in anophthalmic sockets and deposits on prosthetic eyes were used for the first time in this study. It is recommended that in clinical practice, inflammation grades for both socket and companion eye conjunctivae be compared, when determining if prosthesis-induced inflammation is present. The finding that more discharge was associated with more conjunctival inflammation is logical but the finding that less inflammation was associated with more deposits is counter-intuitive to those familiar with the contact lens literature. The apparently benign nature of at least some deposits on the prostheses raises questions about the maintenance of prosthetic eyes. We conclude that the simple presence of deposits is unlikely to be linked with inflammation of the conjunctiva in wearers of prostheses, who like those in this study, cleaned their prostheses regularly but not frequently.
Topics: Anophthalmos; Conjunctivitis; Eye, Artificial; Humans; Viscosity
PubMed: 23336714
DOI: 10.1111/cxo.12004 -
Journal of Medical Genetics Mar 1993An interstitial deletion of the region q22.1-->q22.3 of chromosome 14 is described in a child with bilateral anophthalmia, dysmorphic features including micrognathia,... (Review)
Review
An interstitial deletion of the region q22.1-->q22.3 of chromosome 14 is described in a child with bilateral anophthalmia, dysmorphic features including micrognathia, small tongue, and high arched palate, developmental and growth retardation, undescended testes with a micropenis, and hypothyroidism. Interstitial deletions of the long arm of chromosome 14 are extremely rare, but this case seems to confirm that the region q22 is specifically concerned with pituitary and eye development.
Topics: Abnormalities, Multiple; Anophthalmos; Child, Preschool; Chromosome Banding; Chromosome Deletion; Chromosomes, Human, Pair 14; Developmental Disabilities; Facial Bones; Flow Cytometry; Genitalia, Male; Humans; Hypothyroidism; Karyotyping; Male; Pituitary Gland; Skull
PubMed: 7682620
DOI: 10.1136/jmg.30.3.251 -
Look what else we found--clinically significant abnormalities detected during routine ROP screening.Indian Journal of Ophthalmology May 2015The purpose of this study was to report the spectrum of anterior and posterior segment diagnoses in Asian Indian premature infants detected serendipitously during...
PURPOSE
The purpose of this study was to report the spectrum of anterior and posterior segment diagnoses in Asian Indian premature infants detected serendipitously during routine retinopathy of prematurity (ROP) screening during a 1 year period.
METHODS
A retrospective review of all Retcam (Clarity MSI, USA) imaging sessions during the year 2011 performed on infants born either <2001 g at birth and/or <34.1 weeks of gestation recruited for ROP screening was performed. All infants had a minimum of seven images at each session, which included the dilated anterior segment, disc, and macula center and the four quadrants using the 130° lens.
RESULTS
Of the 8954 imaging sessions of 1450 new infants recruited in 2011, there were 111 (7.66%) with a diagnosis other than ROP. Anterior segment diagnoses seen in 31 (27.9%) cases included clinically significant cataract, lid abnormalities, anophthalmos, microphthalmos, and corneal diseases. Posterior segment diagnoses in 80 (72.1%) cases included retinal hemorrhages, cherry red spots, and neonatal uveitis of infective etiologies. Of the 111 cases, 15 (13.5%) underwent surgical procedures and 24 (21.6%) underwent medical procedures; importantly, two eyes with retinoblastoma were detected which were managed timely.
CONCLUSIONS
This study emphasizes the importance of ocular digital imaging in premature infants. Visually significant, potentially life-threatening, and even treatable conditions were detected serendipitously during routine ROP screening that may be missed or detected late otherwise. This pilot data may be used to advocate for a possible universal infant eye screening program using digital imaging.
Topics: Female; Humans; Infant; Infant, Newborn; Infant, Premature; Male; Neonatal Screening; Retina; Retinal Hemorrhage; Retinopathy of Prematurity; Retrospective Studies
PubMed: 26139795
DOI: 10.4103/0301-4738.159859 -
The British Journal of Ophthalmology Jul 1995Congenital anophthalmos is a rare condition in which intervention at an early age can stimulate orbital expansion and maximise facial symmetry. Much is still unknown,...
BACKGROUND
Congenital anophthalmos is a rare condition in which intervention at an early age can stimulate orbital expansion and maximise facial symmetry. Much is still unknown, however, regarding the degree of soft tissue and bony orbital growth achieved using the orbital expanders presently available.
METHODS
A retrospective review of 59 congenitally anophthalmic orbits in 42 patients was carried out.
RESULTS
The soft tissue and bony orbital expansion achieved using serial solid shapes is reported, and experience with hydrophilic expanders and inflatable silicone expanders is reviewed.
CONCLUSION
Although serially fitted solid shapes in the orbit lead to increased expansion of orbital soft tissue and bone compared with no orbital implant, further orbital tissue enlargement is required. The inflatable silicone expander may allow more rapid and extensive orbital tissue expansion, but design changes are needed to achieve this.
Topics: Anophthalmos; Child, Preschool; Eye, Artificial; Eyelids; Female; Follow-Up Studies; Humans; Infant; Male; Orbit; Retrospective Studies; Silicones; Water
PubMed: 7662633
DOI: 10.1136/bjo.79.7.667 -
Journal of Experimental Zoology. Part... Nov 2020Life in complete darkness has driven the evolution of a suite of troglobitic features in the blind Mexican cavefish Astyanax mexicanus, such as eye and pigmentation...
Life in complete darkness has driven the evolution of a suite of troglobitic features in the blind Mexican cavefish Astyanax mexicanus, such as eye and pigmentation loss. While regressive evolution is a hallmark of obligate cave-dwelling organisms, constructive (or augmented) traits commonly arise as well. The cavefish cranium has undergone extensive changes compared with closely-related surface fish. These alterations are rooted in both cranial bones and surrounding sensory tissues such as enhancements in the gustatory and lateral line systems. Cavefish also harbor numerous cranial bone asymmetries: fluctuating asymmetry of individual bones and directional asymmetry in a dorsal bend of the skull. This asymmetry is mirrored by the asymmetrical patterning of mechanosensory neuromasts. We explored the relationship between facial bones and neuromasts using in vivo fluorescent colabeling and microcomputed tomography. We found an increase in neuromast density within dermal bone boundaries across three distinct populations of cavefish compared to surface-dwelling fish. We also show that eye loss disrupts early neuromast patterning, which in turn impacts the development of dermal bones. While cavefish exhibit alterations in cranial bone and neuromast patterning, each population varied in the severity. This variation may reflect observed differences in behavior across populations. For instance, a bend in the dorsal region of the skull may expose neuromasts to water flow on the opposite side of the face, enhancing sensory input and spatial mapping in the dark.
Topics: Animals; Anophthalmos; Biological Evolution; Caves; Characidae; Craniofacial Abnormalities; Darkness; Facial Bones; Imaging, Three-Dimensional; Quantitative Trait, Heritable; Skull
PubMed: 32030873
DOI: 10.1002/jez.b.22932 -
Ophthalmic Epidemiology Oct 2021Infants with anophthalmia or microphthalmia frequently have co-occurring birth defects. Nonetheless, there have been few investigations of birth defect patterns among...
PURPOSE
Infants with anophthalmia or microphthalmia frequently have co-occurring birth defects. Nonetheless, there have been few investigations of birth defect patterns among these children. Such studies may identify novel multiple malformation syndromes, which could inform future research into the developmental processes that lead to anophthalmia/microphthalmia and assist physicians in determining whether further testing is appropriate.
METHODS
This study includes cases with anophthalmia/microphthalmia identified by the Texas Birth Defects Registry from 1999 to 2014 without clinical or chromosomal diagnoses of recognized syndromes. We calculated adjusted observed-to-expected ratios for two - through five-way birth defect combinations involving anophthalmia/microphthalmia to estimate whether these combinations co-occur more often than would be expected if they were independent. We report combinations observed in ≥5 cases.
RESULTS
We identified 653 eligible cases with anophthalmia/microphthalmia (514 [79%] with co-occurring birth defects), and 111 birth defect combinations, of which 44 were two-way combinations, 61 were three-way combinations, six were four-way combinations and none were five-way combinations. Combinations with the largest observed-to-expected ratios were those involving central nervous system (CNS) defects, head/neck defects, and orofacial clefts. We also observed multiple combinations involving cardiovascular and musculoskeletal defects.
CONCLUSION
Consistent with previous reports, we observed that a large proportion of children diagnosed with anophthalmia/microphthalmia have co-occurring birth defects. While some of these defects may be part of a sequence involving anophthalmia/microphthalmia (e.g., CNS defects), other combinations could point to as yet undescribed susceptibility patterns (e.g., musculoskeletal defects). Data from population-based birth defect registries may be useful for accelerating the discovery of previously uncharacterized malformation syndromes.
Topics: Anophthalmos; Child; Cleft Lip; Cleft Palate; Humans; Infant; Microphthalmos; Syndrome
PubMed: 33345678
DOI: 10.1080/09286586.2020.1862244 -
Indian Journal of Ophthalmology Jul 2021
Topics: Anophthalmos; Humans; Prostheses and Implants
PubMed: 34146049
DOI: 10.4103/ijo.IJO_1438_21 -
Arquivos Brasileiros de Oftalmologia 2018To evaluate the outcomes of dermis-fat graft procedure for orbital volume replacement in anophthalmic socket.
PURPOSE
To evaluate the outcomes of dermis-fat graft procedure for orbital volume replacement in anophthalmic socket.
METHODS
A retrospective chart review was performed studying all dermis-fat graft surgeries done at King Khlaed Eye Specialist Hospital in the last 10-year period. Sixty-two anophthalmic socket carriers underwent dermis-fat graft during the study period. Data were collected on characteristics of the patients, postoperative complications, cosmesis, and functional results such as the ability to hold an external prosthesis.
RESULTS
Mean age of the patients included in the study was 34.2 ± 9.7 years. There were 38.7% of patients with grade 3 anophthalmic socket, 64.5% of patients had an acquired anophthalmic socket, and dermis-fat graft was performed as a secondary procedure in 61.3% of patients. Postoperative complications included lagophthalmos (22.6%), graft necrosis (17.7%), pyogenic granuloma (12.9%), decreased graft size (12.9%), malpositioned lids (3.2%), and volume deficiency (3.2%). The prosthesis was held in place in 49 patients (79%) preoperatively and in 55 patients (88.7%) postoperatively.
CONCLUSION
Dermis-fat graft is an excellent option for congenital or acquired as well as primary or secondary anophthalmic sockets, with or without contraction. The outcomes are favorable, and complications are rare.
Topics: Adipose Tissue; Adolescent; Adult; Aged; Aged, 80 and over; Anophthalmos; Autografts; Child; Child, Preschool; Dermis; Female; Humans; Infant; Male; Middle Aged; Orbit; Orbital Implants; Prosthesis Implantation; Retrospective Studies; Young Adult
PubMed: 30208137
DOI: 10.5935/0004-2749.20180073 -
The British Journal of Ophthalmology Dec 2007To report clinical findings relating to the lacrimal system in congenital clinical anophthalmos and severe blind microphthalmos.
AIM
To report clinical findings relating to the lacrimal system in congenital clinical anophthalmos and severe blind microphthalmos.
METHODS
A retrospective (up to 2003) and prospective (2004 onwards) study of the notes of 60 consecutive patients treated surgically with highly hydrophilic self-inflating expanders for congenital anophthalmos or severe blind microphthalmos between 1997 and 2006. The lacrimal drainage system was always probed and irrigated under general anaesthesia before any other procedure was started.
RESULTS
Nine patients were excluded due to possible misdiagnosis because of previous lid or orbit surgery elsewhere or due to missing data. The analysis therefore included 23 girls and 28 boys aged between 1 and 90 months (median age: 4 months). Twenty-three patients presented with unilateral and 18 with bilateral anophthalmos, and 10 had unilateral microphthalmos; consequently, 102 orbits (of which, 69 were with probable pathology) were available for assessment. In unilateral cases, the lacrimal system on the normal side was never affected. On the anophthalmic or microphthalmic side, the lacrimal system was normal in 17 orbits only (24.6%). The most frequent finding was canalicular stenosis (40 orbits; 58%). Common canaliculus stenosis was observed in 5 orbits (7.3%) and nasolacrimal duct obstruction in 7 orbits (10.1%). There were no cases of punctal anomaly.
CONCLUSIONS
In congenital clinical anophthalmos the lacrimal system is affected in up to 78% of cases, mostly due to canalicular stenosis. Even if there is no clear evidence of an embryological connection, this association is certainly not a random finding.
Topics: Anophthalmos; Blindness; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Lacrimal Apparatus; Lacrimal Duct Obstruction; Male; Microphthalmos; Nasolacrimal Duct; Prospective Studies; Retrospective Studies; Severity of Illness Index
PubMed: 17567663
DOI: 10.1136/bjo.2007.120121