Treatment of congenital anophthalmos with self-inflating polymer expanders: a new method

Congenital anophthalmos is a rare malformation in which the optic vesicle f ails to develop. This leads to a small bony orbit, a constricted mucosal so cket, short eyelids, reduced palpebral fissure and malar hypoplasia, The tr eatment includes both aesthetic and functional aspects. Therefore, a two-st ep procedure is described using a new self-inflating hydrogel expander. A l ens-shaped expander with a diameter of 8 mm expands the lids and the mucosa l socket to allow insertion of an eye prosthesis. As a second step, orbital expansion is performed with a spherical device. The expanders absorb lacri mal fluid from the mucosal socket or tissue fluid and start swelling when i mplanted in the orbital tissue The insertion of an expander into the orbit as well as into the conjunctiva l pocket including its fixation by a single suture took only a few minutes and was an easy procedure. The expansion of the small conjunctival sockets was successfully completed in all cases within a period of 2-4 weeks. The w eight (=volume in mi) of devices increased from 0.15-1.5 g (lens-shaped exp ander; weight in grams = volume in mi) respectively, 0.3-3.5 g (spherical d evice). The expanders inserted in orbital tissue increased from 0.4-4.4 g, This is equivalent to a 10 to 11 fold increase in their water-free volumes. Orbital expansion with spherical devices in combination with the inserted eye prosthesis enlarges the lid and palpebral fissures also. In contrast to conventional silicon balloon expanders, the procedure using self-inflating hydrogel expanders is simple and highly efficient.