PRIMARY DERMIS FAT GRAFT IMPLANTATION IN ORBIT AFTER EVISCERATION

Background: Orbital implants allow for cosmesis and volume replacement of an eviscerated eye. Dermis fat graft is a viable alternative to alloplastic implants as a primary orbital implant following ocular evisceration. Aim/Objectives: To provide evidence for dermal fat graft as a safe and stable orbital volume replacement following ocular evisceration. Methodology: A prospective, interventional, non-comparative case series of patients who had an primary autologous dermis graft after evisceration.All the patients fulfilling the criteria were identified. At 6 weeks post-operatively, patients received an ocular prosthesis. The volume of the dermis-fat grafted globe was measured at 1 month and 9 months post-operatively by plain magnetic resonance imaging of the orbit. Results: Ten patients underwent ocular evisceration and dermis fat graft implant.Nine patients completed the study.Out of 10 patients 60% (6) were males and 40% (4) were females.Suture abscess was noted in 20% patients, hair growth in the dermis in 10%, sub conjunctival cysts in 10% patients.Cosmetic outcome showed very good result in 50% patients with good prosthetic motility in 60%. Conclusion: This case series shows that the use of a dermis graft is a safe and effective new technique to facilitate orbital rehabilitation. It is hypothesised that the extra surface area produced with a dermis graft preserves the fornices and allows a larger implant.