Abstract
Enucleation in young children often results in retarded orbital growth ipsilaterally. The need for an implant that will naturally grow with the child, like Dermis-fat Graft (DFG), for managing the anophthalmia has been of interest over the years. To evaluate the use of DFG as an implant for volume replacement post-enucleation. A prospective non-comparative case series involving 18 consecutive children who had DFG either primarily or secondarily in conjunction with enucleation for intraocular pathologies, from December 2007 to September 2012, at the ophthalmology unit, Korle-Bu. Data from patients who had a minimum of three months follow up(FUP) were analysed. Complete covering of DFG with healthy conjunctiva, increase in volume of DFG, and presence or absence of complications. Fifteen patients were analysed, aged nine months to ten years (mean (SD), 3.7±2.7years). Eight (53.3%) were females. Thirteen (86.7%) DFGs were secondary and 2(13.3%) primary. Indications for enucleation were intraocular retinoblastoma (n=10, 66.7%), unexplained retinal detachment mimicking retinoblastoma (n=3,20.0%), anterior staphyloma (n=1,6.7%) and medulloepithelioma (n=1,6.7%). Fourteen (93.3%) patients showed increase in volume of DFG. Time for Conjunctival reepithelialisation of the dermal surface was four to fourteen weeks (mean/median=5.5/4.0). Complications encountered were infection (n=1,6.7%), infection with necrosis (n=1,6.7%), melanosis /keratinization (n=2, 13.3%) and cysts(n=2,13.3%). The patients were followed up for 3 to 54 months (mean/median 20.13 /16.00). DFG for management of post-enucleation anophthalmia in Ghanaian children showed 93.3% success.
Highlights
The need for an implant that will naturally grow with the child, like autogenous Dermis-fat Grafts (DFG), has been of interest over the years.[5,6]
A preliminary study in Ghanaian children which looked at the use of DFG for management of anophthalmia post enucleation had demonstrated initial success of 91%
This study is aimed at evaluating the use of DFG as an orbital implant for volume replacement post-enucleation in Ghanaian children and the associated complications over a five year period
Summary
Enucleation in young children often results in retarded orbital growth ipsilaterally due to soft tissue volume loss in the anophthalmic socket.[1,2,3] Management of anophthalmia consisted of fixed-diameter sphere within the muscle cone plus prosthetic shell which is often changed to keep up with the growing child.[4]The need for an implant that will naturally grow with the child, like autogenous Dermis-fat Grafts (DFG), has been of interest over the years.[5,6] A preliminary study in Ghanaian children which looked at the use of DFG for management of anophthalmia post enucleation had demonstrated initial success of 91%.7 This study is aimed at evaluating the use of DFG as an orbital implant for volume replacement post-enucleation in Ghanaian children and the associated complications over a five year period. Enucleation in young children often results in retarded orbital growth ipsilaterally due to soft tissue volume loss in the anophthalmic socket.[1,2,3] Management of anophthalmia consisted of fixed-diameter sphere within the muscle cone plus prosthetic shell which is often changed to keep up with the growing child.[4]. The need for an implant that will naturally grow with the child, like autogenous Dermis-fat Grafts (DFG), has been of interest over the years.[5,6] A preliminary study in Ghanaian children which looked at the use of DFG for management of anophthalmia post enucleation had demonstrated initial success of 91%.7. This study is aimed at evaluating the use of DFG as an orbital implant for volume replacement post-enucleation in Ghanaian children and the associated complications over a five year period
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