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Related Experiment Videos

Inadequate inferior cul-de-sac in the anophthalmic socket.

R W Neuhaus1, M J Hawes

  • 1Department of Ophthalmology, University of Texas Health Science Center, San Antonio.

Ophthalmology
|January 1, 1992
PubMed
Summary

Conjunctival cul-de-sac fixation surgery improved prosthetic eye retention in 12 patients with acquired anophthalmos and inadequate inferior fornix. The procedure directly fixed the conjunctiva to the periosteum, avoiding external sutures.

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Area of Science:

  • Ophthalmology
  • Oculoplastics

Background:

  • Acquired anophthalmos can lead to an inadequate inferior conjunctival cul-de-sac, compromising prosthetic eye retention.
  • Loss of inferior conjunctival cul-de-sac fixation to the lower eyelid retractor complex is a key issue.

Observation:

  • Preoperative analysis suggested anterior migration of intraconal orbital fat due to absent inferior cul-de-sac fixation.
  • This migration can compromise the inferior fornix and cause superior prolapse of the conjunctiva.

Findings:

  • Conjunctival cul-de-sac fixation surgery directly attached the conjunctiva to the periosteum posterior to the inferior orbital rim.
  • No externalized sutures or stents were required.
  • All 12 patients demonstrated improved prosthetic eye retention; two experienced minor lower eyelid retraction and two had minor entropion, with no need for secondary surgery.

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Implications:

  • Direct conjunctival cul-de-sac fixation is an effective surgical option for acquired anophthalmos with inferior fornix deficiency.
  • The technique offers improved prosthetic retention without the need for external devices.
  • Potential for minor eyelid complications warrants consideration but does not necessitate further surgical intervention in most cases.