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This is a retrospective case series of 11 anophthalmic orbits in eight children. Anophthalmia can result micro-orbitism, congenital fornix atresia, constricted socket, phimotic lids and reduced palpebral aperture. Expanders play an important role in improving the orbital volume and forniceal depth in order for the child to wear a suitable prosthesis in the future. The two issues of orbital volume and forniceal depth have to be dealt with separately. In this study the main focus is the use of hydrogel expanders to increase orbital volume. The authors describe doing this by placing expanders via a lateral canthotomy incision, rather than through the conjunctiva, as is frequently done. They describe the advantage of this as a reduced risk of implant extrusion. The authors have used various sizes of expanders and there is a large variation in age at implantation and time intervals of imaging. This is understandable given the rarity of congenital anophthalmia, however makes it difficult to draw conclusions. Complications included implant extrusion in one case and implant migration in another. This paper does, however, provide an interesting alternative surgical technique for a complex condition.

Outcomes of the use of orbital hydrogel expanders in the management of congenital anophthalmia: CT-based orbital parameter analysis.
Alanazi RR, Schellini SA, Alhussain H, et al.
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Hetvi Bhatt

Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.

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