Surgical management of contracted eye socket

Abstract

Background

Anophthalmia—the absence of an eye—can significantly impact patients’ psychological well-being, affecting self-confidence, body image, social interactions, and contributing to anxiety and depression. Contracted socket, characterized by reduced orbital volume and forniceal depth, poses a major challenge to fitting an ocular prosthesis. This study evaluates the effectiveness of skin grafts and mucous membrane grafts in forniceal reconstruction.

Methods

This prospective case series included 25 patients with varying degrees of contracted sockets treated between October 2020 and December 2023. Etiologies included congenital anophthalmia, chemical burns, radiotherapy, infection, and trauma. Reconstruction was performed using mucous membrane grafts (MMG) or full-thickness skin grafts (FTSG), according to the severity of socket contraction. Outcomes were evaluated based on the ability to retain a prosthesis and patient satisfaction.

Results

Twenty-four of the 25 patients achieved successful prosthesis retention. Complications were minimal and appropriately managed. Serial dilatation was particularly important in preventing re-contracture, especially in Grade 4 sockets.

Conclusions

Simple reconstructive techniques using MMG and FTSG can restore forniceal depth effectively, achieving favorable cosmetic and functional outcomes while minimizing the need for complex procedures.