Smith and Nesi’s Ophthalmic Plastic and Reconstructive Surgery

pp 1131-1173


Evaluation and Management of the Anophthalmic Socket and Socket Reconstruction

  • David R. JordanAffiliated withUniversity of Ottawa Eye Institute Email author 
  • , Stephen R. KlapperAffiliated withKlapper Eyelid and Facial Plastic Surgery

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The absence of an eye due to malformation, disease, or trauma is an exceptionally difficult situation for patients, and the management of the anophthalmic socket has long been a challenge for the ophthalmologist and ocularist. In the past decade, there have been numerous developments and refinements in anophthalmic socket surgery with respect to implant material and design, implant wrapping, implant–prosthesis coupling, and socket volume considerations. Anophthalmic surgery is no longer simply about replacing a diseased eye with an orbital implant and delegating the procedure to inexperienced surgeons or to the junior resident staff. As with other microsurgical ophthalmic procedures, enucleation and eviscerations should be performed meticulously to attain the best functional and cosmetic result and to avoid deformities that may compound the patients’ already challenging situation.