Volume augmentation of the anophthalmic orbit with cross-linked collagen (Zyplast)

Injectable glutaraldehyde cross-linked collagen (Zyplast) has been used to augment the soft-tissue volume of the anophthalmic sockets of five patients. Follow-up of more than 1 year has demonstrated that this material can be used safely with long-lasting results. Enophthalmos and pseudoptosis were treated by injecting Zyplast transconjunctivally into the muscle cone. Superior sulcus deepening was treated by injecting Zyplast transcutaneously into the superior extraconal fat posterior to the orbital septum ("preaponeurotic fat pad"). In some cases the size of the ocular prosthesis required can be decreased. Surgical volume augmentation of the socket and superior sulcus was averted in all five patients.