title: Autologous dermis graft at the time of evisceration or enucleation.
abstract: OBJECTIVE
  To present a new technique using autologous dermis graft at the time of enucleation or evisceration to replace the ocular surface area lost when the corneal scleral button is excised.
  
  
  METHODS
  A retrospective, interventional, non-comparative case series of patients who had an autologous dermis graft placed to assist in closure of Tenon's capsule and conjunctiva at the time of enucleation or evisceration. Medical records were reviewed and the following variables were recorded: age, sex, history of previous ocular surgery or radiation treatment, indication for surgery, type of surgery, laterality, type of orbital implant, size of implant, length of follow up, and complications.
  
  
  RESULTS
  Nine patients were identified (three male, six female) Five had enucleation with implant placement and four had evisceration with implant placement. Four individuals received unwrapped porous polyethylene spherical implants, three received silicone implants, and two received hydroxylapatite implants. Follow up ranged from 30 to 112 weeks (mean (SD), 61 (28) weeks). No operative or early complications were observed. One patient who had enucleation after two rounds of brachytherapy for uveal melanoma developed subsequent late exposure of the implant. There were no complications involving the graft donor site.
  
  
  CONCLUSIONS
  This small 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. It may also allow the implant to be placed more anteriorly which assists with both implant and prosthesis motility.
authors.affiliation: Center for Facial Appearances, Salt Lake City, Utah, USA.
authors.forename: M Reza
authors.initials: MR
authors.lastname: Vagefi
authors.forename: Tristan F W
authors.initials: TF
authors.lastname: McMullan
authors.forename: John R
authors.initials: JR
authors.lastname: Burroughs
authors.forename: David K
authors.initials: DK
authors.lastname: Isaacs
authors.forename: Angelo
authors.initials: A
authors.lastname: Tsirbas
authors.forename: George L
authors.initials: GL
authors.lastname: White
authors.forename: Richard L
authors.initials: RL
authors.lastname: Anderson
authors.forename: John D
authors.initials: JD
authors.lastname: McCann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015353:Eye Enucleation / Q000379:methods*; D017234:Eye Evisceration / Q000379:methods*; D005137:Eye, Artificial; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000000981:diagnostic imaging; D019919:Prosthesis Implantation / Q000379:methods; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods*; D014057:Tomography, X-Ray Computed