Orbital administration of fillers for optimization of symmetry in patients with microphthalmos or acquired anophthalmic sockets: a review.
Author: Alejandra Herranz-Cabarcos
Base Hospital / Institution: Consorci Sanitari integral Moisés Broggi
ePoster presentation
Abstract ID: 24-135
Purpose
To analyze the published experience on the use of fillers to optimize symmetry in microphthalmic or anophthalmic sockets. Based on the results obtained, a treatment algorithm will be proposed.
Methods
A bibliographic search was carried out in the main databases (PubMed/Medline, Google Scholar, Clinical trials, Dialnet, Scopus). A ‘search equation’ was established based on representative terms. Advanced search systems, Boolean and position operators were used. Restrictive criteria applied to the results were language (English, Spanish) and a minimum level of evidence of case series. Information regarding filler, infiltration technique, anesthesia, treatment setting, changes in exophthalmometry in relation to injected volume, complications, follow-up time and retreatment rate was recorded.
Results
Fourteen articles were included in the final analysis. Various materials have been used as fillers, including autologous fat, calcium hydroxyapatite, collagen, hyaluronic acid or polyacrylamide gel. Peribulbar and retrobulbar injection techniques were applied, associated with similar anesthesia. Treatments were performed ambulatory in most cases.Complications were reported in 6 to 20% of cases, the most frequent being the development of vasovagal symptoms and the most serious retrobulbar hemorrhage. A ratio of 1 mm of variation in exophthalmometry per 1 ml of injected product was established for all fillers.Patient follow-up was limited in most studies to 12 months. Observed retreatment rates were very inconsistent.
Conclusion
The application of fillers in orbital asymmetries associated with anophthalmic cavities is a safe, simple practice that requires few resources. At a minimum, it should be taken into account as a therapeutic option in patients in whom complex reconstructive surgery is contraindicated. A systematic evaluation of these patients is proposed, including an imaging test, an initial treatment with orbital infiltration followed by treatment, if necessary, of the patient’s upper eyelid and middle third. Based on the review carried out, hyaluronic acid would be the filler of choice.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Rebeca | Rosés-Saiz | Consorci Sanitari integral Moisés Broggi |
| Consorci Sanitari integral Moisés Broggi |
