Anophthalmos - a Conjunctival Implant

Overview

The authors submit information on the completed development of a conjunctivalimplant and its use for modelling of the conjunctival sac in inborn and acquiredanophthalmos. Plastic solution in inborn types is used for cosmetic reasons inunilateral degenerative and consecutive anophthalmos. The orbit and adnexa areusually only little affected. The other indication is secondary anophthalmos afterenucleation of the bulbus when the conjunctival sac is thretened by retractiondue to actinotherapy of the orbital area or a scarry process after a previous injury.The implant is a convex concave circular-shaped plate with a diameter of 20 mmthe centre of which is thinner to facilitate manipulation during insertion. It ismade from silicone rubber which has properties characterized as implant grade.Before the implantation proper the plate is adjusted by cutting to the desired size.The surgical procedure proper in inborn anophthalmos involves external canthotomywith gradual preparation of the conjunctiva into the Tenon space in theregion of the eyelids to create a broad crevice into which the adjusted implantcan be inserted. The operation is completed by closing the canthotomy supplementedby partial tarsorrhaphy using unabsorbable suture. Thus the implant issufficiently fixed in the newly created ocular space. The silicone inlay is left for3-6 months to allow epithelization of the surgical site round the implant. Inacquired anophthalmos with retraction of the conjunctival sac in the first stagethe lower transitory fold is released before insertion of the implant by thecul-de-sac method. The function of the implant is modelling of the conjunctival space in anophthalmos to maintain an adequate space for fornices for laterinsertion of the permanent prosthesis. The implant is manufactured at present byELLA-CS.

Key words:
anophthalmos - anophthalmic pit - implant - plastic operation of theconjunctival sac - silicone rubber