Proposing a New Classification for Managing Prostaglandin-Induced Enophthalmos in Glaucoma Patients
Author: Alessandra Di Maria
Base Hospital / Institution: Humanitas Research Hospital
ePoster presentation
Abstract ID: 25-157
Purpose
To propose a new clinical classification for prostaglandin-induced enophthalmos in glaucoma patients and to outline a therapeutic approach based on severity grading.
Methods
A two-phase observational study was conducted at the Oculoplastic Unit, IRCCS Humanitas Research Hospital (2005–2023). Phase 1 focused on developing a composite clinical score based on six parameters: Hertel exophthalmometry, upper eyelid fold position, MRD1, levator function, entropion presence, and fat pad atrophy. Patients were stratified into four severity groups (none, mild, moderate, severe). Phase 2 evaluated therapeutic strategies: calcium hydroxylapatite (CAHY) fillers and autologous fat grafting depending on severity.
Results
A total of 120 glaucoma patients treated long-term with prostaglandin analogs were analyzed. Most patients exhibited moderate to severe enophthalmos. The new classification system showed a strong correlation between clinical findings and disease severity. CAHY fillers provided lasting volume augmentation in moderate cases, while combined CAHY and autologous fat grafting improved tissue quality and orbital volume in severe cases, reducing scar retraction and improving cosmetic outcomes.
Conclusion
This novel classification provides an effective and reproducible framework for assessing prostaglandin-induced enophthalmos. The therapeutic algorithm based on severity allows individualized management, improving both functional and aesthetic outcomes. Early recognition and treatment may prevent irreversible orbital changes and enhance patient satisfaction. Future research should focus on validating the classification across larger multicenter cohorts.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Alessandro | Gaeta | University of Genoa |
| Vanessa | Ferraro | Humanitas San Pio X |
| Filippo | Confalonieri | Humanitas Research Hospital |
| Gianmaria | Barone | Humanitas Research Hospital |
| Costanza | Tredici | Humanitas Research Hospital |
