Autologous dermis graft at the time of evisceration or enucleation.
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.
Vagefi
M Reza
MR
Center for Facial Appearances, Salt Lake City, Utah, USA.
McMullan
Tristan F W
TF
Burroughs
John R
JR
Isaacs
David K
DK
Tsirbas
Angelo
A
White
George L
GL
Anderson
Richard L
RL
McCann
John D
JD
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