Superior rectus/levator complex in acquired anophthalmic socket repaired with spheric implant—a computed tomography scan and topographic study

AIM:To determine whether the levator palpebrae superioris(LPS)/superior rectus(SR)muscle complex,can influence the position of the upper lid and fornix in acquired anophthalmic sockets.METHODS:This comparative non-randomized and non-interventional study included retrospective data of 21 patients with unilateral acquired anophthalmic sockets repaired with spheric implants.High-resolution computed tomography(CT)measurements of the LPM/SR muscle complex and clinical topographic position of the upper lid,superior and inferior fornix depth in primary gaze position were evaluated.Demographic data were presented as frequency and percentage proportions and quantitative variables comparing the socket measurements with the normal contralateral orbit was statistically analyzed using non-parametric tests considering P<0.05.RESULTS:The anophthalmic orbits had a significantly shorter LPS length(P=0.01)and significantly thicker SR(P=0.02)than the normal orbit.Lagophthalmos was present in anophthalmic sockets but not in normal orbits(P=0.002),while levator function was normal in both(P>0.05,all comparisons).The superior fornix depth was similar in the anophthalmic socket and the contralateral normal orbit(P=0.192)as well the inferior fornix depth(P=0.351).CONCLUSION:Acquired anophthalmic sockets repaired with spheric implants have shorter LPS,thicker SR,and more lagophthalmos than normal orbits.The relationship of the LPS and SR with other orbital structures,associated with passive or active forces acting in the final position of the lids and external ocular prosthesis should be further investigated.

Dermis-fat graft for contracted socket reconstruction in an indigenous black population, Southwestern Nigeria

The purpose of this case series is to report the indications for dermis-fat grafting and the outcome of treatment in orbital soft tissue contraction among patients in a tertiary center. It is a retrospective, consecutive, interventional case series where all patients with orbital soft tissue contraction who had dermis-fat grafting were studied. All nine patients in our series underwent secondary dermis-fat grafting for orbital soft tissue reconstruction. The major cause for contracted socket was surgical eye removal following trauma. Eight of nine patients had no orbital implants inserted at the time of primary eye removal and eight patients have had failed orbital reconstructive procedures. Satisfactory cosmetic results were reported in all patients post-operatively. Dermis-fat grafting for contracted socket reconstruction was found to give satisfactory cosmetic results in our studied population.