title: Tarsal patch-flap for orbital implant exposure.
abstract: The authors determine the efficacy of a new technique, the tarsal patch-flap, in the management of postenucleation and postevisceration porous orbital implant exposures that are recalcitrant to other surgical approaches. All patients treated during a 30-month period with recurrent orbital implant exposures who failed at least one surgical attempt at defect closure were treated using a tarsal patch-flap, a fornix-based tarsoconjunctival flap from the upper eyelid. Eight patients, six after enucleation and two after evisceration, were treated with a tarsal patch-flap. Five implants were porous polyethylene and three were hydroxyapatite. The defect size ranged from 4 mm to 12 mm (largest dimension). All eight patients have maintained closure of their defects for a mean follow-up of 13.8 months (range, 4-30 months). The vascularized tarsal patch-flap provides an excellent alternative surgical approach to the management of recurrent orbital implant exposures recalcitrant to Tenon-conjunctival advancement and autologous fascia grafting.
authors.affiliation: Department of Ophthalmology, University of Massachusetts Medical Center, Worcester 01655, USA.
authors.forename: C N
authors.initials: CN
authors.lastname: Soparkar
authors.forename: J R
authors.initials: JR
authors.lastname: Patrinely
mesh_terms: D001672:Biocompatible Materials; D017886:Durapatite; D015353:Eye Enucleation / Q000009:adverse effects; D017234:Eye Evisceration / Q000009:adverse effects; D005143:Eyelids / Q000601:surgery*; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000209:etiology / Q000601:surgery*; D006801:Humans; D009916:Orbital Diseases / Q000209:etiology / Q000601:surgery*; D020273:Orbital Implants; D011095:Polyethylenes; D012008:Recurrence; D013524:Surgical Flaps; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials; D011095:Polyethylenes; D017886:Durapatite