ADAPTACIÓNES DE CONFORMADORES OSMÓTICOS Y RIGIDOS COMO TRATAMIENTO DE PACIENTES PEDIÁTRICOS CON ANOFTALMIA Y MICROFTALMIA CONGÉNITA

Abstract

Anophthalmia and congenital microphthalmia are developmental disorders of the ocular structures caused by failure or deformation of the optic vesicle. Environmental factors such as exposure to chemicals (benzimidazole), as well as maternal infections like rubella, toxoplasmosis, cytomegalovirus, and varicella, are mentioned as etiological factors. Additionally, exposure to solvents, radiation, or drugs like thalidomide, isotretinoin, warfarin, and alcohol during pregnancy can contribute to these conditions. The objective of this study is to describe the use of osmotic hydrogel expanders in a case series of patients diagnosed with anophthalmos and congenital microphthalmos. The different phases of treatment prior to ocular prosthesis adaptation are presented. Two cases from “Optica Silva” were selected, one with a diagnosis of congenital anophthalmos and the other with unilateral congenital microphthalmos. Patients underwent medical history evaluation, assessment of the healthy eye, and physical examination of the ocular cavity. Subsequently, hydrogel spheres were adapted and replaced monthly to gradually expand the conjunctival sacs. Once the initial expansion of the fornices was achieved, the design and adaptation of rigid PMMA (polymethyl methacrylate) conformers were performed. The combined use of these devices allowed for the adaptation of ocular prostheses in the treated individuals. As a result, it is evident that early treatment with osmotic conformers is possible, enabling gradual expansion of the conjunctival sacs with minimal discomfort for the patient and avoiding long-term facial asymmetry.