Results of surgical treatment and rehabilitation of patients with post-traumatic subatrophy and anophthalmic syndrome in combination with bone deformities of the orbit

Abstract

BACKGROUND: Ocular prosthetics remains an important and actual task in the rehabilitation of patients with anophthalmos of various origins. AIM: To increase the effectiveness of cosmetic prosthetics in patients at the formation of a primary and/or delayed supporting stump with simultaneous reconstructive procedures on the orbital bone structures. MATERIALS AND METHODS: A retrospective analysis of patients with subatrophy and anophthalmos with deformities of the orbital walls was carried out. Results were analyzed according to the criteria for the severity of clinical signs enophthalmos, deepening of the superior orbitopalpebral sulcus, prosthesis mobility. RESULTS: 22 patients with orbital bone deformities were operated and examined; they underwent surgery on the orbital walls in combination with evisceration with posterior scleral pole resection, neurectomy and implantation of a spherical endoprosthesis (in modifications) in 12 patients and delayed stump plasty in 10 patients with anophthalmos. It was possible to eliminate enophthalmos in 18 patients, to correct the retraction of the upper eyelid on the prosthesis side in 19 patients, and to significantly increase the mobility of the prosthesis in 9 patients. CONCLUSIONS: Carrying out a combined surgical procedure aimed at restoring a voluminous mobile primary or delayed supporting stump and eliminating the deformation of the orbital walls with restoring the lost volume creates conditions for optimal individual ocular prosthetics, significantly reduces prosthesis enophthalmos, increases its mobility and improves cosmetic results of rehabilitation.