Abstract
To evaluate the outcomes of dermis-fat graft procedure for orbital volume replacement in anophthalmic socket. A retrospective chart review was performed studying all dermis-fat graft surgeries done at King Khlaed Eye Specialist Hospital in the last 10-year period. Sixty-two anophthalmic socket carriers underwent dermis-fat graft during the study period. Data were collected on characteristics of the patients, postoperative complications, cosmesis, and functional results such as the ability to hold an external prosthesis. Mean age of the patients included in the study was 34.2 ± 9.7 years. There were 38.7% of patients with grade 3 anophthalmic socket, 64.5% of patients had an acquired anophthalmic socket, and dermis-fat graft was performed as a secondary procedure in 61.3% of patients. Postoperative complications included lagophthalmos (22.6%), graft necrosis (17.7%), pyogenic granuloma (12.9%), decreased graft size (12.9%), malpositioned lids (3.2%), and volume deficiency (3.2%). The prosthesis was held in place in 49 patients (79%) preoperatively and in 55 patients (88.7%) postoperatively. Dermis-fat graft is an excellent option for congenital or acquired as well as primary or secondary anophthalmic sockets, with or without contraction. The outcomes are favorable, and complications are rare.
Highlights
The use of a dermis-fat graft (DFG) to replace volume in an anophthalmic cavity was first described in 1978(1,2)
Data were collected on characteristics of the patients, postoperative complications, cosmesis, and functional results such as the ability to hold an external prosthesis
There were 38.7% of patients with grade 3 anophthalmic socket, 64.5% of patients had an acquired anophthalmic socket, and dermis-fat graft was performed as a secondary procedure in 61.3% of patients
Summary
The use of a dermis-fat graft (DFG) to replace volume in an anophthalmic cavity was first described in 1978(1,2). Significant volume may need to be replaced in cases of advanced phthisis bulbi, sockets that have undergone multiple surgeries, cases of implant extrusions associated with necrosis of conjunctiva and Tenon capsule. An autologous implant does not require special preparation, storage, or transportation, thereby reducing expenses. This procedure can offer excellent cosmesis and functional results. Some questions remain regarding the indications and outcomes of DFG These questions spurred us to review the success rates and complications of DFG at our institute. To our knowledge, this is the largest sample size involving this relatively new procedure that has been reviewed. Statistical analysis Data were analyzed based on patient demographics, associated lid anomalies, conjunctival status, status of
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