COSMETIC OUTCOME OF AUTOGENOUS DERMIS FAT GRAFT AS AN ORBITAL IMPLANT AFTER ENUCLEATION

Authors

  • Zeeshan Kamil LRBT Teaching Tertiary Eye Hospital, Karachi Pakistan
  • Qirat Qurban LRBT Teaching Tertiary Eye Hospital, Karachi Pakistan

DOI:

https://doi.org/10.55519/JAMC-01-9920

Keywords:

anophthalmic socket, dermis fat graft, enucleation, orbital implant

Abstract

The surgical method of removing the complete intact globe while leaving the extraocular muscles and orbital fat behind is called as enucleation. The intention behind this study is to share the experience of autogenous dermis fat graft as an orbital implant following enucleation and its cosmetic outcome. It was a prospective study conducted at the Orbit and Oculoplastic department of LRBT Tertiary Teaching Eye hospital from July 2018 to June 2019. Eighty-five patients were recruited for this study belonging to either gender with ages ranging from 20 to 50 years. None of the recruited patients had undergone prior enucleation or evisceration. All the patients were informed and counseled about the surgical modus operandi and the expected outcomes and verbal consent was taken from each patient along with approval from the hospital’s ethical review committee before proceeding with the surgery. Every participant underwent primary enucleation followed by autogenous dermis fat graft orbital implant and followed up for duration of up to 3 months after the surgical procedure. Results: At ninety days after the procedure, 78.2% of patients had a very good cosmetic result. Conclusion: The placement of autogenous dermis fat graft as an orbital implant following primary enucleation has a good accomplishment rate with excellent cosmetic outcome.

Author Biography

Zeeshan Kamil, LRBT Teaching Tertiary Eye Hospital, Karachi Pakistan

Consultant Opthalomologist

References

Soll DB. Management of the anophthalmic socket and techniques of enucleation, evisceration and exentration:surgical procedures and management of complications. In: Duane TD, editor. Duane’s Clinical Ophthalmology, Vol 5 Philadelphia, Lippincott Williams and Wilkins, 1992; p.407–23.

Custer PL, Trinkaus KM. Porous implant exposure: Incidence, management, and morbidity. Ophthalmic Plast Reconstr Surg 2007;23(1):1–7.

Soll DB. The anophthalmic socket. Ophthalmology 1982;85(5):205–8.

Quaranta-Leoni FM, Moretti C, Sposato S, Nardoni S, Lambiase A, Bonini S. Management of porous orbital implants requiring explantation: a clinical and histopathological study. Ophthal Plast Reconstr Surg 2014;30(2):132–6.

McElnea EM, Ryan A, Fulcher T. Porous orbital implant exposure: the influence of surgical technique. Orbit 2014;33(2):104–8.

Custer PL, Trinkaus KM. Porous implant exposure: Incidence, management, and morbidity. Ophthalmic Plast Reconstr Surg 2007;23(1):1–7.

Salour H, Owji N, Farahi A. Two-stage procedure for management of large exposure defects of hydroxyapatite orbital implant. Eur J Ophthalmol 2003;13(9-10):789–93.

Sami D, Young S, Petersen R. Perspective on orbital enucleation implants. Surv Ophthalmol 2007;52(3):244–65.

Schmitzer S, Simionescu C, Alexandrescu C, Burcea M. The anophthalmic socket - reconstruction options. J Med Life 2014;7:23–9.

Hintschich CR, Beyer-Machule CK. Dermis fatty tissue transplant as primary and secondary orbital implant. Complications and results. Ophthalmologe 1996;93(5):617–22.

Smith B, Petrelli R. Dermis fat graft as a movable implant within the muscle cone. Am J Ophthalmol 1978;85(1):62–6.

Starks V, Freitag SK. Postoperative Complications of Dermis-Fat Autografts in the Anophthalmic Socket 2018. Semin Ophthalmol 2018;33(1):112–5.

Bonavolonta G, Tranfa F, Salicone A, Strianese D. Orbital Dermis fat graft using periumbilical tissue. Plast Reconstr Surg 2000;105(1):23–6.

Sihota R, Sujatha Y, Betharia SM. The fat pad in dermis fat grafts. Ophthalmology. 1994; 101:231-234.

Soll DB: Evolution and current concepts in the surgical treatment of the anophthalmic orbit. Ophthal Plast Reconstr Surg 1986;101(2):163–71.

Mitchell KT, Hollsten DA, White WL, O'Hara MA. The autogenous dermis-fat orbital implant in children. J AAPOS 2001;5(6):367–9.

Nentwich MM, Scheibitz-Walter K, Hirneiss C, Hintschich C. Dermis fat grafts as primary and secondary orbital implants. Orbit 2014;33(1):33–8.

Guberina C, Hornblass A, Meltzer MA, Soarez V, Smith B. Autogenous dermis fat orbital implantation. Arch Ophthalmol 1983;101(10):1586–90.

Satyanarayana M, Preethy M. A Clinical Study of Efficacy of Dermis Fat Graft as Primary Orbital Implant Following Evisceration and Enucleation. IOSR J Dent Med Sci 2018;17(9):45–50.

Karaca EE, Ekici F, Akçam HT, Konuk O. The use of osseointegration and orbital implants in the management of orbital exenteration or severe contracted sockets/Ileri kontrakte soket ve ekzenterasyon hastalarinda kemik ile entegre implant cerrahisi ve orbita protezi uygulamasi. Turkish J Ophthalmol 2014;44(2):127–32.

Baum SH, Schmeling C, Pförtner R, Mohr C. Autologous dermis – Fat grafts as primary and secondary orbital transplants before rehabilitation with artificial eyes. J Craniomaxillofac Surg 2018;46(1):90–7.

Lu YL, Chen ZT, Tsai IL. Dermis-fat graft as treatment of early implant exposure in a postpenetrating keratoplasty patient with nontraumatic eyeball rupture. Taiwan J Ophthalmol 2020;10(2):134–7.

Lin C, Liao S. Long-term complications of different porous orbital implants: a 21-year review. Br J Ophthalmol 2017;101(5):681–5.

Published

2022-01-02