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    Acrylic conformers effective in congenital anophthalmia

    Treatment requires close collaboration among patient, ophthalmologist, ocularist


    Such devices have been available for about 20 years, but do not always provide the desired results, Dr. Johnson said.

    “There have been reported complications including migration,” he said.

    Another approach is a saline tissue expander implanted into the deep socket using titanium T-plate fixation at the lateral orbital rim. This approach requires surgery and multiple computed tomography (CT) scans. Inserting the device sometimes disrupts the important lateral canthus.

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    Dermis fat grafting can also expand the orbit. Typically the graft is placed around age 4 to 5 years. Drawbacks include unpredictable growth, atrophy, and poor socket elasticity that prevent the socket from responding well to future prosthetic enlargement.

    Other ophthalmologists have attacked the problem using surgery, including canthotomy and osteotomies, but this also can leave scars and may expose the patient to radiation from CT scans increasing the risk of leukemia and brain cancer.

    In addition, some research suggests that repeated use of general anesthesia can impair a child’s cognitive development.

    Using acrylic expanders

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