Abstract
Objectives:To evaluate the outcomes of secondary autologous dermis-fat graft as an orbital implant in anophthalmic sockets.Methods:In this prospective study, which was conducted at Jinnah Post Graduate Medical Centre, Karachi, between January 2015 and January 2020, we evaluated 12 patients between the ages of four and 60 years. Most of the adults were victims of trauma, whereas children were known cases of retinoblastoma or trauma and all underwent enucleation. All of them were primarily treated elsewhere and not offered primary orbital implants. We performed autologous dermis-fat graft as an orbital implant in these patients harvesting graft from gluteal region and followed them up to look for complications.Results:Out of 12 patients two went into failure, while rest of the patients showed successful outcome. All patients underwent successful surgery. Initially, a silicon conformer was placed, which was later on replaced with artificial prosthetic eye.Conclusion:Regardless of the small sample size, this procedure proved to be a safe and effective method for augmenting orbital volume in anophthalmic sockets in children and adults.
Highlights
The dermis fat graft (DFG) was first described by Smith and Petrelli in 19781 for anophthalmic socket reconstruction and since has become a widely employed technique by which we can increase orbital volume in enucleated patients.[2]
Regardless of the popularity of alloplastic grafts, one should not overlook autologous grafts as an orbital implant, because complications such as exposure and extrusion have been reported from alloplastic grafts and there is lesser chance of migration or extrusion of the graft with the use of autologous tissue as compared to the use of alloplastic grafts. In this prospective study, we aimed to evaluate the outcomes of secondary autologous dermis fat graft as an orbital implant in anophthalmic sockets
The primary surgery in all the patients was enucleation whereas one patient had a concomitant DFG at the time of primary surgery
Summary
The dermis fat graft (DFG) was first described by Smith and Petrelli in 19781 for anophthalmic socket reconstruction and since has become a widely employed technique by which we can increase orbital volume in enucleated patients.[2]. An Autologous DFG consists of dermis and subcutaneous fat, after removing the epidermis, and is a sustainable volume replacement implant. Pak J Med Sci March - April 2021 Vol 37 No 2 www.pjms.org.pk 426 for primary enucleation and evisceration.[3,4,5,6] The dermis in the DFG is thought to improve vascularization and reduces the chances of fat atrophy. It functions as a barrier, opposing fatty augmentation. The graft provides, a soft tissue and surface lining with vascular support, but it functions as a temporary biologic dressing.[7,8] The gluteal area is the site mostly used to harvest the graft, but regions such as the abdomen and the periumbilical can function as a graft harvesting site
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