The treatment of enophthalmos by orbital injection of fat autograft.

Abstract

To evaluate the effects of retro-orbital intramuscular cone injection of fat in the treatment of posttraumatic enophthalmos in both patients with intact globes and those patients who have had globes removed. Case series. Private practice involving an otolaryngologist and an ophthalmologist. Three groups of patients were treated: group 1 included those patients with an intact globe; group 2, patients with an orbital implant following enucleation; and group 3, patients with no orbital implant following enucleation. Autogenous fat was harvested from the abdomen using a microsuction lipectomy technique. The fat was injected into the intramuscular cone in the retrobulbar or retroimplant space using a 14-gauge needle. Sustained improvement of enophthalmos measured by Hertel's exophthalmometry in those patients with an intact globe. Subjective appearance of prosthesis by physician and patient were used for end points in patients whose globes were removed. In group 1, all patients were able to maintain a correction to within 1 mm of the normal eye. In groups 2 and 3, all patients had a subjective improvement in appearance, but they had development of enophthalmos if the prosthesis was decreased in size. Seven patients (64%) required multiple injections. Retro-orbital injection of fat autografts allows correction of persistent posttraumatic enophthalmos.