In severe cases of microphthalmos or anophthalmos, the bony orbital cavity is often too small to allow one to create a satisfactory socket for a prosthesis. An omnidirectional expansion of the orbit, by osteotomies done in a step-like fashion, allows the creation of a larger bony cavity and improves the symmetry of the face. The risks of the craniotomy and of the mobilization of the free bone pieces are discussed.