Contracted anophthalmic socket repair.

PURPOSE: The aim of this paper is to describe a simple method for severely contracted anophthalmic socket repair in which a silicone sphere is used as an expander for widening and deepening severely contracted conjunctival sacs. PATIENTS AND
METHOD: This method was used in five patients. Each patient had undergone previous operations but they could not wear artificial eyes and there was no hope of performing any other type of surgical procedure successfully. In our surgical method, the severely contracted conjunctiva is cut deeply at the desired level of the upper and lower eyelid fornix. A certain amount of scar tissue is excised and a silicone sphere is placed under the eyelids. The eyelid margins are sutured to each other with a double-running nylon suture. After four months, the eyelid fissure is opened and a special round-shaped artificial eye is inserted. The original silicone sphere is used as an expander in the evenings during the next two or three months.
RESULTS: This procedure was used successfully in four of the five cases. In one case the silicone sphere was lost and cicatrization reoccurred. The longest follow-up time is now five years, the shortest, one year.
CONCLUSION: Using a silicone sphere as an expander can be an alternative surgical method for contracted anophthalmic socket repair. The main advantage of this method is its simplicity. In order to use this procedure, good cooperation between doctor and patient is essential.