Pathologie et chirurgie des cavités anophtalmes

Ocular prosthesis reduces the cosmetic deformity produced by the anophthalmic orbit. Prosthetic management involves both the ophthalmologist and the ocularist. The conjunctival sac must adequately maintain the ocular prosthesis. When treating the anophthalmic socket, orbital volume deficit should be considered first. Then, the conjunctival sac is treated and eyelid malposition will be restored when the prosthesis is fitted. Osteointegrated implants offer an alternative to conventional surgery, providing a satisfactory aesthetic result with low associated morbidity. For congenital microphthalmos or anophthalmos, reconstruction of the conjunctival sac using conformers of increasing size is advocated first. In case of failure, expander within the orbit or osteotomy expansion may be necessary. Eyelid malposition will be treated when the definitive prosthesis is fitted.