Periumbilical fat auto-graft associated to a porous orbital implant for socket reconstruction after enucleation. (3rd July 2016)

• Record Type: Journal Article
• Authors: Medel, Ramon; Alonso, Tirso; Pelaez, Francisco; Vasquez, LuzMaria
• Is Part Of: Orbit. Volume 35:Number 4(2016)
• Page Start: 181
• Page End: 186
• Publication Date: 2016-07-03
• Subjects: Enucleation -- fat auto-graft -- anopthalmic socket -- orbital impland; Eye-sockets -- Surgery -- Periodicals; Eye-sockets -- Diseases -- Periodicals; Orbit -- surgery -- Periodicals; Orbital Diseases -- Periodicals; 617.7
• DOI: 10.1080/01676830.2016.1176206
• Languages: English
• ISSNs: 0167-6830

Abstract

ABSTRACT: Having to remove the sclera, fat and the optic nerve in patients undergoing an enucleation, translates in a larger volume that needs to be replaced to achieve good motility and aesthetic results. Using a 20 or 22 mm implant can only partially replace the removed volume. We report the results of our enucleation technique, which includes the use of a porous orbital implant combined with a primary fat graft to replace a higher percentage of the removed volume to achieve a better cosmetic outcome and to avoid implant related complications in high risk patients. Prospective, non-randomized study of enucleated patients for whom porous orbital implantation was performed with anterior placement of a fat auto-graft. The development of implant extrusion or exposure was recorded as well as the presence of conjunctival wound dehiscence and infection. Orbital volume was clinically and radiologically evaluated as well. Twenty-eight patients were included, with a postop follow-up of at least 6 months (6-79 months). No cases of migration or extrusion were found. One case of a large exposure resolved completely. All MRI demonstrated proper implant-graft integration and vascularisation. The aesthetic result and the symmetry were very adequate, with Hertel differences of less than 2 mm in all cases and good motility range. The fat graft is well tolerated, showing low incidence of implant-related complications whilst maintaining good volume and motility.