Autologous fat transfer for orbital volume augmentation in sockets with small nonseeing eyes

Abstract

End-stage ocular diseases usually end up with atrophic bulbi or phthisis bulbi leading to orbital volume loss which needs to be addressed. We studied the use of autologous fat for volume augmentation of the orbit because it is minimally invasive and allows early rehabilitation with the use of an artificial eye. It was a prospective, interventional study. A total of 14 eyes of 14 patients with atrophic bulbi with shrinkage or phthisis bulbi with no perception of light (PL) and aged older than 18 years were included for the study purpose. Painful or inflamed eyes or suspected intraocular tumors were excluded. An autologous fat graft was obtained from the lower abdomen or buttocks and injected into the retrobulbar space using a 20-gauge cannula after adequate peribulbar anesthesia. Outcomes measures were patient satisfaction, change in Hertel's exophthalmometry, vertical and horizontal palpebral aperture, and socket volume. Hertel exophthalmometry showed a significant improvement both with and without an artificial eye from 14.92±2.3mm to 16.71±1.94mm (p-value 0.003 without an artificial eye). The vertical palpebral aperture also showed a significant improvement from 5±1.70mm to 6.71±1.58mm (p-value<0.001). There was a significant reduction in the socket volume from 1.22ml to 0.39ml (p-value<0.001). No local or donor site complications were seen. Autologous fat transfer is a minimally invasive, safe, and effective procedure for orbital volume augmentation in small, nonseeing eyes. The short-term outcome of our study was good in most patients and can be considered for such patients.