Orbital volume augmentation with calcium hydroxyapatite filler in anophthalmic enophthalmos

Abstract

Purpose:To report the long-term results of orbital volume augmentation using calcium hydroxyapatite filler injections in patients with anophthalmic sockets.Methods:Twelve eligible patients with post-enucleation socket syndrome (PESS) and small orbital volumes were included in our study. In this investigation, 1.5 mL injectable calcium hydroxyapatite (Radiesse) was utilized in an off-label application under local anesthesia. We evaluated the effect of orbital volume augmentation for correction of enophthalmos.Results:Five women and seven men with a mean age of 35 years (range, 21-72 years) were included in the study. The mean follow-up was 19.5 months (range, 16-27 months). Enophthalmos and deep superior sulcus were reduced in all patients during all follow-up visits postoperatively. The mean improvement of enophthalmos was 2.58 mm (range, 1-5 mm) and the improvement in deformity grading of superior sulcus was 0.83 (range, 0-4 grade). The mean marginal reflex distance increased by 0.6 mm (range of -1 to 3 mm). Complications included increase in ptosis in two cases and extrusion of the filler accompanied by discoloration of the skin in one case.Conclusion:The use of injectable calcium hydroxyapatite for orbital volume restoration in anophthalmic sockets is a simple, fast, and minimally invasive method with considerable long-term effects and low complications.

Investigation of the Orbital Arterial Distribution Using Image Superimposition to Determine Safe Zones for Retrobulbar Injection and to Prevent Filler Complications

“…8 For these reasons, the use of fillers is ideal for orbital volume enhancement in both anophthalmic orbits and sighted eyes. [4][5][6][7][8] The dynamic viscosity of filler avoids disturbing the function of extraocular muscles and optic neurovascular entities-such disturbance can occur in an unpredictable manner when using hard implantation materials. 8 Moreover, retrobulbar filler injection has a minimal adverseevent profile [17][18][19] as well as acceptable longevity and biocompatibility.…”

“…Moreover, a satisfactory outcome may require multiple injections, which represent a potential source of inflammation. 5,6 Biomaterials such as collagen also cannot be used because they pose the risk of anterior migration of the graft and blood-vessel occlusion. 16 An ideal material for orbital volume enhancement would exhibit properties that satisfy both aesthetic and functional requirements.…”

Anophthalmic Socket Syndrome: Prevalence, Impact and Management Strategies

“…Calcium hydroxyapatite gel (Radiesse) is a biocompatible material with longstanding effect and it has been suggested for orbital volume augmentation, with relatively long‑term effects and low complications. 69 Volume enhancement using this technique may be however limited to orbits that demonstrate significant fibrosis resulting from multiple surgeries, trauma or radiation. 70 Hyaluronic acid fillers are relatively easy to administer, but may migrate and are temporary.…”

Treatment outcomes of oral propranolol in the treatment of periocular infantile capillary hemangioma and factors predictive of recurrence and incomplete resolution: A multi-centric study

“…[ 1 2 3 ] They constitute the most common benign vascular ocular tumors in the pediatric age group. [ 4 ] IH has a well-defined natural history, classically manifest as a rapid proliferative phase in the first three months of birth followed by spontaneous involution phase, which lasts for several years. [ 5 6 ] Congenital hemangiomas (CH) are rarer and usually present as fully grown lesions at birth with minimal change in the size of the lesion after birth.…”