Das Syndrom der anophthalmischen Höhle oder das „post enucleation socket syndrome“ – neue und bewährte chirurgische Konzepte

 

 Buy Article Permissions and Reprints

Zusammenfassung

Die Orbitahöhle kann nach Enukleation oder Eviszeration atrophieren und durch sekundären Volumenmangel zu einem insuffizienten Prothesensitz führen. Dieses als Postenucleation Socket Syndrome (PESS) bezeichnete Krankheitsbild macht eine sekundäre Augmentation des Orbitavolumens erforderlich. Die Möglichkeiten der Korrektur reichen von sekundären Orbitaimplantaten und Austausch eines vorhandenen Orbitaimplantats bis zu subperiostalen Orbitabodenimplantaten und injizierbaren Materialien zur Volumenaugmentation der Orbitahöhle. Die einzelnen Verfahren werden mit Berücksichtigung der Indikationsstellung beleuchtet und diskutiert.

Abstract

The orbital volume after enucleation or evisceration might shrink over time due to atrophy of the orbital fat and connective tissue. This can lead to prosthesis misfit and an unsatisfactory cosmetic result. This so-called post enucleation socket syndrome (PESS) needs a secondary orbital volume augmentation. The techniques for orbital volume augmentation are secondary orbital implants or implant exchange, orbital floor implants or injectable augmentation. The surgical possibilities are described and discussed with special attention to indications and chances.

• Literatur

• 1 Klett A, Guthoff R. Deckung von Orbitaimplantaten mit muskelgestielter autologer Sklera – eine mikrochirurgische Modifikation zur Verbesserung der Prothesenmotilität. Ophthalmologe 2003; 100: 449-452
  PubMedGoogle Scholar
• 2 Viswanathan P, Sagoo MS, Olver JM. UK national survey of enucleation, evisceration and orbital implant trends. Br J Ophthalmol 2007; 91: 616-619
  CrossrefPubMedGoogle Scholar
• 3 Hintschich C, Baldeschi L. [Rehabilitation of anophthalmic patients. Results of a survey]. Ophthalmologe 2001; 98: 74-80
  CrossrefPubMedGoogle Scholar
• 4 Thaller VT. Enucleation volume measurement. Ophthal Plast Reconstr Surg 1997; 13: 18-20
  CrossrefPubMedGoogle Scholar
• 5 Quaranta-Leoni FM. Treatment of the anophthalmic socket. Curr Opin Ophthalmol 2008; 19: 422-427
  CrossrefPubMedGoogle Scholar
• 6 Hintschich CR, Beyer-Machule CK. [Dermal fat transplant as autologous orbital implant]. Klin Monatsbl Augenheilkd 1996; 208: 135-141
  Article in Thieme ConnectPubMedGoogle Scholar
• 7 Sadiq SA, Mengher LS, Lowry J et al. Integrated orbital implants – a comparison of hydroxyapatite and porous polyethylene implants. Orbit 2008; 27: 37-40
  CrossrefPubMedGoogle Scholar
• 8 Norda AG, Meyer-Rüsenberg HW. Hydroxylapatitplombenimplantation nach Enukleation – Erfahrungen in 112 Fällen. Spektrum Augenheilkd 1998; 12: 101-107
  CrossrefPubMedGoogle Scholar
• 9 Norda AG, Meyer-Rüsenberg HW. Langzeitresultate mit der Implantation von Hydroxylapatit als Bulbusersatz. Ophthalmologe 2000; 97: 91-99
  CrossrefPubMedGoogle Scholar
• 10 Tyers AG, Collin JR. Orbital implants and post enucleation socket syndrome. Trans Ophthalmol Soc U K 1982; 102: 90-92
  PubMedGoogle Scholar
• 11 Smit TJ, Koornneef L, Zonneveld FW et al. Computed tomography in the assessment of the postenucleation socket syndrome. Ophthalmology 1990; 97: 1347-1351
  CrossrefPubMedGoogle Scholar
• 12 Custer PL, McCaffery S. Complications of sclera-covered enucleation implants. Ophthal Plast Reconstr Surg 2006; 22: 269-273
  CrossrefPubMedGoogle Scholar
• 13 Inkster CF, Ng SG, Leatherbarrow B. Primary banked scleral patch graft in the prevention of exposure of hydroxyapatite orbital implants. Ophthalmology 2002; 109: 389-392
  CrossrefPubMedGoogle Scholar
• 14 Smith B, Bosniak S, Nesi F et al. Dermis-fat orbital implantation: 118 cases. Ophthalmic Surg 1983; 14: 941-943
  PubMedGoogle Scholar
• 15 Spivey BE, Allen L, Stewart WB. Surgical correction of superior sulcus deformity occurring after enucleation. Am J Ophthalmol 1976; 82: 365-370
  CrossrefPubMedGoogle Scholar
• 16 Rose GE, Sigurdsson H, Collin R. The volume-deficient orbit: clinical characteristics, surgical management, and results after extraperiorbital implantation of silastic block. Br J Ophthalmol 1990; 74: 545-550
  CrossrefPubMedGoogle Scholar
• 17 Anagnostopoulos A, Meyer-Rüsenberg HW. Postenukleation-Socket-Syndrom, Behandlung mit Rippenknorpeltransplantat, Vortrag DOG 2014. Klin Monatsbl Augenheilkd
  PubMedGoogle Scholar
• 18 Crochelet O, Maalouf T, Duron S et al. [Efficacy and tolerability of highly crosslinked hyaluronic acid injections in the management of the enophthalmous orbit]. J Fr Ophtalmol 2012; 35: 441.e1-e7
  PubMedGoogle Scholar
• 19 Kim SS, Kawamoto HK, Kohan E et al. Reconstruction of the irradiated orbit with autogenous fat grafting for improved ocular implant. Plast Reconstr Surg 2010; 126: 213-220
  CrossrefPubMedGoogle Scholar
• 20 Vagefi MR, McMullan TF, Burroughs JR et al. Orbital augmentation with injectable calcium hydroxylapatite for correction of postenucleation/evisceration socket syndrome. Ophthal Plast Reconstr Surg 2011; 27: 90-94
  CrossrefPubMedGoogle Scholar
• 21 Schittkowski MP, Guthoff RF. Injectable self inflating hydrogel pellet expanders for the treatment of orbital volume deficiency in congenital microphthalmos: preliminary results with a new therapeutic approach. Br J Ophthalmol 2006; 90: 1173-1177
  CrossrefPubMedGoogle Scholar
• 22 Li T, McCann J, Goldberg R. Orbital volume augmentation in anophthalmic patients using injectable hydrogel implants. Minneapolis, MN: ASOPRS Abstracts; 2003: 91
  Google Scholar