Osteoplastic Reconstruction of Post-enucleatic Microorbitalism

Area of Science:

• Ophthalmology
• Plastic Surgery
• Craniofacial Surgery

Background:

• Microorbitalism can occur in patients enucleated in infancy for retinoblastoma.
• This condition results from reduced growth stimulation of the eyeball and surrounding tissues.
• The orbit is anatomically composed of the frontal bone, maxilla, ethmoid bone, and zygoma.

Purpose of the Study:

• To evaluate the efficacy of tripod osteotomy in expanding the orbit in adult patients with microorbitalism secondary to retinoblastoma.
• To assess changes in orbital volume and width following the surgical procedure.

Main Methods:

• Tripod osteotomy was performed on adult patients with microorbitalism.
• Orbital volume was measured using Aquarius Workstation software.
• Orbital width was assessed via preoperative and postoperative 3D facial bone CT scans.
• Preoperative and postoperative photographs were used for visual assessment.

Main Results:

• Orbital volume increased by an average of 2.2 cm³ (21.4%), from 10.3 cm³ to 12.5 cm³.
• 3D facial CT confirmed an increase in orbital width.
• Aesthetic improvements were noted in postoperative photographs.

Conclusions:

• Tripod osteotomy is a viable surgical option for orbital expansion in microorbitalism secondary to retinoblastoma.
• The procedure effectively corrects orbital asymmetry and improves aesthetics.
• This technique realigns orbital bones, zygoma, and maxilla, similar to its use in other congenital abnormalities.