Severe enophthalmos following irradiation of the anophthalmic socket: surgical approaches

The combination of enucleation plus irradiation often leads to a significant orbital volume loss and severe enophthalmos. Surgery for enophthalmos correction involves the replacement of intraorbital volume with autogenous or alloplastic material, either subperiorbitally, or in the muscle cone. Subperiorbital implants technically are easiest to perform, but implant absorption, migration, and other complications can be cosmetically unacceptable. Alternatively, approaching the muscle cone through a lateral subperiorbital dissection avoids trauma to the irradiated conjunctiva; allows easy access to the muscle cone for implantation of silicone spheres glass beads, or RTV silicone; and provides an excellent cosmetic result.