Long-Term Results of Autologous Auricular Cartilage Graft Applied in Anophthalmic Orbits Unable to Wear Prosthesis.

Yi-Lin Liao,Shu-Ya Wu,Yueh-Ju Tsai

doi:10.1155/2019/7197063

Yi-Lin Liao, Shu-Ya Wu + Show 1 more

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https://doi.org/10.1155/2019/7197063

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Abstract

In anophthalmic patients, shallow lower fornices make wearing ocular prostheses impossible and maintaining normal social activities difficult. This study retrospectively investigated the long-term surgical outcomes of autologous auricular cartilage grafting for contracted orbits. From 1995 to 2013, 29 anophthalmic contracture sockets with inadequate lower fornices and poor prosthesis retention presented to Chang Gung Memorial Hospital in Linkou, Taiwan, were treated using this surgical method. The success rate, aesthetic outcome, recurrence, and complications were analyzed. Among the 29 patients, 15 were women, 14 were men, their mean age was 45 years, and the mean follow-up time was 52 months (range = 6–159 months). Satisfactory lid position was achieved in 25 cases (86%), and lower fornix retraction recurred in four cases (14%). Neither donor site morbidity nor auricular deformity was noted during the follow-up period. Therefore, an auricular cartilage graft can be used successfully as a compatible spacer for anophthalmic patients with shallow lower fornices and prosthesis-fitting problems in long-term follow-up.

Highlights

Anophthalmic patients who wear an ocular prosthesis often experience orbital and eyelid abnormalities, such as enophthalmos, upper eyelid ptosis, deep superior sulcus, lower eyelid malposition, and shallow lower fornix. ese symptoms constitute what is referred to as postenucleation socket syndrome (PESS) [1]
Cases whose contracture of the inferior fornices leads to the inability to maintain an ocular prosthesis are categorized as moderate socket contracture
An ongoing challenge for surgeons is developing a method to reconstruct moderate to severe contracture sockets with a lining deficit of the fornix, especially in nonCaucasian populations with prominent fibrosis tendency. Both scarring of the orbital fibrous connective tissue and disturbances to the conjunctiva contribute to socket contracture. erefore, this study aims to report surgical outcomes for the use of autologous auricular cartilage grafting for moderate socket contracture in non-Caucasian populations as a reference for further studies

Summary

Introduction

Anophthalmic patients who wear an ocular prosthesis often experience orbital and eyelid abnormalities, such as enophthalmos, upper eyelid ptosis, deep superior sulcus, lower eyelid malposition, and shallow lower fornix. ese symptoms constitute what is referred to as postenucleation socket syndrome (PESS) [1]. Ese symptoms constitute what is referred to as postenucleation socket syndrome (PESS) [1]. Anophthalmic patients who wear an ocular prosthesis often experience orbital and eyelid abnormalities, such as enophthalmos, upper eyelid ptosis, deep superior sulcus, lower eyelid malposition, and shallow lower fornix. To manage these cosmetic disfigurements, multiple surgeries may be conducted in anophthalmic orbits. Mild contracture refers to cicatricial entropion of the lower eyelids caused by fibrotic contracture in the posterior lamella. Cases whose contracture of the inferior fornices leads to the inability to maintain an ocular prosthesis are categorized as moderate socket contracture. Severe socket contracture manifests as marked vertical and horizontal forniceal contracture [3] and may occur following trauma, recurrent inflammation caused by an inadequate prosthesis, or radiotherapy

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