J Korean Ophthalmol Soc.  2013 Apr;54(4):545-551. 10.3341/jkos.2013.54.4.545.

Outcomes of Autogenous Dermis Fat Grafting with Different Donor Sites in Exposed Porous Orbital Implants

Affiliations
  • 1Department of Ophthalmology, Chonbuk National University Medical School, Jeonju, Korea. ahnmin@jbnu.ac.kr

Abstract

PURPOSE
To compare the outcomes of autogenous dermis fat grafting with different donor sites in the treatment of exposed porous orbital implants.
METHODS
The present study retrospectively evaluated the medical records of 17 patients (17 anophthalmic eyes) who had undergone autogenous dermis fat grafting based on the diagnosis of exposed porous orbital implants and were regularly followed up for at least 12 months since the surgery from January 2001 to December 2010. The patients were divided into 2 groups (thigh and abdomen) according to the site of the donor grafting. The treatment outcome and complications were compared between the 2 groups.
RESULTS
The success rate of thigh dermis fat grafting was 88.9% (8/9) and 100.0% (8/8) in the abdominal dermis fat grafting, and there was no statistically significant difference between the 2 groups (p = 1.000). Regarding ocular complications, graft tissue infection (thigh 11.1%, abdomen 0%) and superior sulcus deformity (thigh 22.2%, abdomen 25.0%) were present. Regarding donor site complications, tenderness (thigh 55.6%, abdomen 25.0%), dehiscence (thigh 22.2%, abdomen 25.0%) and scar formation (thigh 33.3%, abdomen 25.0%) were observed. In the gait associated complications, pain (thigh 55.6%, abdomen 25.0%) and limping (thigh 22.2%, abdomen 12.5%) were observed. The rate of all complications showed no statistically significant difference between the thigh dermis fat grafting and the abdominal dermis fat grafting (all p > 0.05).
CONCLUSIONS
Thigh and abdomen can both be considered as an effective donor site for the autogenous dermis fat grafting in the treatment of exposed porous orbital implants.

Keyword

Dermis fat graft; Donor site; Exposed porous orbital implant

MeSH Terms

Abdomen
Cicatrix
Congenital Abnormalities
Dermis
Gait
Humans
Medical Records
Orbit
Orbital Implants
Retrospective Studies
Thigh
Tissue Donors
Transplants
Treatment Outcome

Figure

  • Figure 1. (A) Preoperative photograph of an exposed porous orbital implant at a 54-year-old male. (B) Post-operative (1 week after dermis fat graft) photograph. (C) Post-operative (1 month after dermis fat graft) photograph. (D) At post-operative 6 months after dermis fat graft, no evidence of re-exposure is observed.


Cited by  2 articles

Two Cases of Actinomyces Infection in a Hydroxyapatite Orbital Implant with a Motility Peg
Min Gyu Lee, Kyung In Woo, Yoon Duck Kim
J Korean Ophthalmol Soc. 2014;55(5):755-760.    doi: 10.3341/jkos.2014.55.5.755.

Effects of Contracted Anophthalmic Socket Reconstruction with Oral Mucosa Graft
Kyoung Hwa Bae, In Cheon You, Min Ahn
J Korean Ophthalmol Soc. 2016;57(2):188-194.    doi: 10.3341/jkos.2016.57.2.188.


Reference

References

1. Su GW, Yen MT. Current trends in managing the anophthalmic socket after primary enucleation and evisceration. Ophthal Plast Reconstr Surg. 2004; 20:274–80.
Article
2. Viswanathan P, Sagoo MS, Olver JM. UK national survey of enucleation, evisceration and orbital implant trends. Br J Ophthalmol. 2007; 91:616–9.
Article
3. Dutton JJ. Coralline hydroxyapatite as an ocular implant. Ophthalmology. 1991; 98:370–7.
Article
4. Li T, Shen J, Duffy MT. Exposure rates of wrapped and unwrapped orbital implants following enucleation. Ophthal Plast Reconstr Surg. 2001; 17:431–5.
Article
5. McNab A. Hydroxyapatite orbital implants. Experience with 100 cases. Aust N Z J Ophthalmol. 1995; 23:117–23.
6. Oestreicher JH, Liu E, Berkowitz M. Complications of hydroxyapatite orbital implants. A review of 100 consecutive cases and a comparison of Dexon mesh (polyglycolic acid) with scleral wrapping. Ophthalmology. 1997; 104:324–9.
Article
7. Custer PL, Trinkaus KM. Porous implant exposure: Incidence, management, and morbidity. Ophthal Plast Reconstr Surg. 2007; 23:1–7.
Article
8. Nunery WR, Heinz GW, Bonnin JM, et al. Exposure rate of hydroxyapatite spheres in the anophthalmic socket: histopathologic correlation and comparison with silicone sphere implants. Ophthal Plast Reconstr Surg. 1993; 9:96–104.
9. Remulla HD, Rubin PA, Shore JW, et al. Complications of porous spherical orbital implants. Ophthalmology. 1995; 102:586–93.
Article
10. Yoon JS, Lew H, Kim SJ, Lee SY. Exposure rate of hydroxyapatite orbital implants a 15-year experience of 802 cases. Ophthalmology. 2008; 115:566–72.
11. Park MS, Kim KS, Baek SH, Lee TS. Management of exposed porous orbital implant with autogenous dermis graft. J Korean Ophthalmol Soc. 2001; 42:1127–32.
12. Hwang K, Kim DJ, Lee IJ. An anatomic comparison of the skin of five donor sites for dermal fat graft. Ann Plast Surg. 2001; 46:327–31.
Article
13. Lee MJ, Khwarg SI, Choung HK, et al. Dermis-fat graft for treatment of exposed porous polyethylene implants in pediatric post-enucleation retinoblastoma patients. Am J Ophthalmol. 2011; 152:244–50.
Article
14. Rosen HM, McFarland MM. The biologic behavior of hydroxyapatite implanted into the maxillofacial skeleton. Plast Reconstr Surg. 1990; 85:718–23.
Article
15. Goldberg RA, Holds JB, Ebrahimpour J. Exposed hydroxyapatite orbital implants. Report of six cases. Ophthalmology. 1992; 99:831–6.
Article
16. Kim YD, Goldberg RA, Shorr N, Steinsapir KD. Management of exposed hydroxyapatite orbital implants. Ophthalmology. 1994; 101:1709–15.
Article
17. Buettner H, Bartley GB. Tissue breakdown and exposure associated with orbital hydroxyapatite implants. Am J Ophthalmol. 1992; 113:669–73.
Article
18. Martin P, Ghabrial R. Repair of exposed hydroxyapatite orbital implant by a tarsoconjunctival pedicle flap. Ophthalmology. 1998; 105:1694–7.
Article
19. Massry GG, Holds JB. Frontal periosteum as an exposed orbital implant cover. Ophthal Plast Reconstr Surg. 1999; 15:79–82.
Article
20. Pelletier CR, Jordan DR, Gilberg SM. Use of temporalis fascia for exposed hydroxyapatite orbital implants. Ophthal Plast Reconstr Surg. 1998; 14:198–203.
Article
21. Rosen CE. The Müller muscle flap for repair of an exposed hydroxyapatite orbital implant. Ophthal Plast Reconstr Surg. 1998; 14:204–7.
Article
22. Soparkar CN, Patrinely JR. Tarsal patch-flap for orbital implant exposure. Ophthal Plast Reconstr Surg. 1998; 14:391–7.
Article
23. Smith B, Petrelli R. Dermis-fat graft as a movable implant within the muscle cone. Am J Ophthalmol. 1978; 85:62–6.
Article
24. Davis RE, Guida RA, Cook TA. Autologous free dermal fat graft. Reconstruction of facial contour defects. Arch Otolaryngol Head Neck Surg. 1995; 121:95–100.
25. van Gemert JV, Leone CR Jr.Correction of a deep superior sulcus with dermis-fat implantation. Arch Ophthalmol. 1986; 104:604–7.
Article
26. Conley JJ, Clairmont AA. Dermal-fat-fascia grafts. Otolaryngology. 1978; 86((4 Pt 1)):ORL-641-9.
Article
27. Nosan DK, Ochi JW, Davidson TM. Preservation of facial contour during parotidectomy. Otolaryngol Head Neck Surg. 1991; 104:293–8.
Article
28. Leaf N, Zarem HA. Correction of contour defects of the face with dermal and dermal-fat grafts. Arch Surg. 1972; 105:715–9.
Article
29. Grillner S, Nilsson J, Thorstensson A. Intra-abdominal pressure changes during natural movements in man. Acta Physiol Scand. 1978; 103:275–83.
Article
30. Hargens AR, Mubarak SJ. Current concepts in the pathophysiology, evaluation, and diagnosis of compartment syndrome. Hand Clin. 1998; 14:371–83.
Article
31. Riou JP, Cohen JR, Johnson H Jr.Factors influencing wound dehiscence. Am J Surg. 1992; 163:324–30.
Article
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