Il trattamento precoce dell'anoftalmia congenita mediante l'utilizzo di autoespansori orbitari idrofilici

Congenital anophthalmia is a rare malformation where the optic vesicle fails to develop. Therefore there is a micro-orbitism, microblepharism and hemifacial hypoplasia. The Authors report early treatment of one patient affected by congenital unilateral anophthalmia who was treated by the equip of the O.U. of Maxillofacial Surgery, S.Gerardo University Hospital of Monza, by self-inflating hydrogel orbital expanders implant. The procedure consisted in implanting, to a 7-months old baby, a lens-shaped auto-expander with 9 ml of final volume for the expansion of the lids and to deepen the fornix. After 3 months, the first device has been substituted with a spherical expander with 2 ml of final volume and after 12 months with a 3 ml device for the orbital skeleton expansion, still in place, in association with an eye prosthesis already at 11 month of age. Today’s follow-up is 30 months, it was studied with clinical ad ultrasound investigations. Surgical procedure was very easy and quick. At the end of lids expansion period, conjunctival sac and fornix were adequate to maintain both the spherical expander and the eye prosthesis. Palpebral rims are symmetrical. The use of spherical expanders together with eye prosthesis permitted to obtain a good facial skeleton symmetry with an excellent aesthetic result. In contrast with the orbital expansive techniques that require the use of silicon balls expanders or conformers, self-inflating hydrogel expanders, are more comfortable for patients and require a less number of interventions