Auricular Cartilage Grafting to Correct Lower Conjunctival Fornix Retraction and Eyelid Malposition in Anophthalmic Patients

Abstract

To evaluate the surgical outcomes of auricular cartilage grafts to correct inferior fornix retraction and eyelid malposition in anophthalmic patients. We performed a retrospective review of consecutive anophthalmic patients whose posterior lamella was lengthened by an autogenous ear cartilage graft to correct inferior fornix retraction and eyelid malposition. Surgical and postoperative complications, additional procedures, recurrence of fornix retraction, eyelid malposition, and donor-site complications were documented. Fifty-four patients (21 men, 33 women) were included in the study. Ages ranged from 5 to 86 years. Thirty-nine patients had moderate fornix retraction and 15 had severe retraction. The mean length of postoperative follow-up was 19.7 months. Successful correction was achieved in 92.6% of cases in the follow-up period. Conjunctival fornix retraction recurred in 4 patients. Two patients developed mild inferior fornix retraction and were able to wear a cosmetic external prosthesis after surgery. The other 2 patients required additional surgeries and could not be fitted with an external prosthesis. Minor complications were observed in 13 patients and were easily managed without cartilage removal. There was no donor-site complication or cosmetic deformity of the ear in any of the patients. Inferior fornix retraction and eyelid malposition in anophthalmic patients can be successfully treated with posterior lamella lengthening using an auricular cartilage graft.