Reconstruction of the Anophthalmic Conjunctival Socket Using Amniotic Membrane
Author: Monika Ilavská
Base Hospital / Institution: Medilux Eye Center Galanta
ePoster presentation
Abstract ID: 25-518
Purpose
This study presents the outcomes of surgeries using cryopreserved amniotic membrane (AM) to increase the volume of a contracted conjunctival socket in post-enucleation patients.
Methods
Patients with unstable ocular prostheses due to fornix contraction were included in the study. Demographic data, causes of eye loss, and time since enucleation were recorded. AM transplantation was performed under local anesthesia and surgical microscope was used for better details. After conjunctival scarring was released, the AM was sutured into the resulting defect. A conformer was inserted postoperatively to maintain the fornix.
Results
Of 51 patients with prosthesis instability, 18 underwent AM transplantation (16 men, mean age 64.8 years; 2 women, mean age 57.5 years). The most common cause of eye enucleation was trauma, with an average time from enucleation of 27.25 years. AM was used alone in 2 cases and combined in others: 7× with horizontal shortening of the lower eyelid, 2× with lateral tarrsorhaphy, 2× with lower lid suspension to the periosteum, 1× with fixation sutures. Upper eyelid ptosis correction was performed in 3 cases. Hyaluronic acid augmentation was used in 2 cases for cosmetic improvement. Stable prosthesis positioning and good aesthetic outcome were achieved in 17 patients; 1 patient did not complete treatment.
Conclusion
Prosthesis instability due to contraction of conjunctival socket has functional and psychological implications. Etiology varies and guides surgical strategy. AM use is proved as effective procedure alone or in combination with other techniques.
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