Korean J Ophthalmol.  2005 Sep;19(3):168-173. 10.3341/kjo.2005.19.3.168.

Correction of Superior Sulcus Deformity and Enophthalmos with Porous High-density Polyethylene Sheet in Anophthalmic Patients

• Choi BH
• Lee SH
• Chung WS

• KMID: 754419
• DOI: http://doi.org/10.3341/kjo.2005.19.3.168

Abstract

PURPOSE
Superior sulcus deformity is the main cosmetic problem in anophthalmic patients. Many methods of correcting enophthalmos have been reported, especially in patients with orbital wall fracture. The purpose of this study is to review the long term results of effectiveness in superior sulcus deformity correction by subperiosteal Medpor (R) sheet implantation in anophthalmic patients. METHODS: Subperiosteal Medpor (R) sheets were used in 11 eyes of 11 anophthalmic patients. To estimate the effectiveness, photographs were taken and exophthalmometric value with their own prosthesis using Hertel exophthalmometer was measured in all patients before and after surgery. RESULTS: The overall cosmetic results in superior sulcus deformity were 'excellent' in 3 (27.3%), 'good' in 6 (54.5%), 'fair' in 2 (18.2%). The overall results in enophthalmos were 'excellent' in 3 (27.2%), 'markedly improved' in 4 (36.4%), 'slightly improved' in 4 (36.4%). Most patients had a marked increase in orbital volume, except two patients. They received irradiation treatment in early childhood so showed unsatisfactory results in both superior sulcus deformity and enophthalmos. CONCLUSIONS: Subperiosteal Medpor (R) sheet implantation is considered to be a reliable and safe procedure without serious complication and with an excellent cosmetic results.

Keyword

Anophthalmos; Enophthalmos; Irradiation; Subperiosteal Medpor (R) sheet implantation; Superior sulcus deformity

MeSH Terms

*Surgical Mesh
Surgery, Plastic
Retrospective Studies
*Polyethylene
Middle Aged
Male
Humans
Female
Eyelid Diseases/*etiology/*surgery
Enophthalmos/*etiology/*surgery
Child
Anophthalmos/*complications
Adult
Adolescent

Figure

• 

  Fig. 1 (A1,2) A 36-year-old man with a superior sulcus deformity, enophthalmos and blunt lateral canthal angle in right eye. (B1,2) Postoperative appearance after subperiosteal Medpor® sheet implantation and lateral canthoplasty. Note resolution of superior sulcus deformity, enophthalmos and sharpened lateral canthal angle.

• 

  Fig. 2 (A1,2) A 30-year-old woman with a superior sulcus deformity and lower eyelid retraction left eye. (B1,2) Postoperative appearance after Medpor® sheet implantation and lateral tarsal strip procedure. Note satisfactory appearance of superior sulcus, enophthalmos and improvement of lower eyelid position.

• 

  Fig. 3 (A1,2) A 35-year-old man with superior sulcus deformity and enophthalmos in right eye. (B1,2) Postoperative excellent appearance of superior sulcus with no enophthalmos.

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