Rigid nylon foil-anchored polytetrafluoroetyhlene (Gore-Tex) sheet stenting for conjunctival fornix reconstruction.
OBJECTIVE
To describe an operative technique that deepens foreshortened conjunctival fornices by providing a scaffold for epithelialization that opposes contractile forces during wound healing.


METHODS
Retrospective interventional case series.


METHODS
Seventeen patients with anophthalmic sockets containing foreshortened conjunctival fornices.


METHODS
Conjunctival fornices was reconstructed with stents of expanded polytetrafluoroethylene (e-PTFE) sheet draped over rigid, 0.8-mm thick-nylon strips that were anchored to the orbital rim. Preoperative and postoperative symptoms, prosthesis retention, fornix depth, and lagophthalmos were assessed.


METHODS
Prosthesis retention, fornix depth, and lagophthalmos.


RESULTS
All 17 patients had preoperative inability to retain their prosthesis. After postoperative follow-up of 47+/-43 months, retention was improved in all patients and was entirely satisfactory in 15 (88%) patients. After reconstruction, the repaired fornix was deep in 7 (41%) patients, adequate to retain a prosthesis in 9 (53%), and shallow in 1 (6%). Lagophthalmos improved in 15 (88%) patients and remained unchanged in 2 (12%). The superior fornix was reconstructed concurrently with the inferior fornix in 6 patients. In these patients, the superior fornix improved to deep (3 patients; 50%) or adequate (2; 33%). In 1 (17%) patient, it remained shallow.


CONCLUSIONS
Rigid, nylon foil-anchored e-PTFE stenting opposes postoperative contracture, improving prosthesis retention, and lagophthalmos. It does not require an additional surgical site for graft harvesting.
Demirci
Hakan
H
Department of Ophthalmology, W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan 48105, USA.
Elner
Susan G
SG
Elner
Victor M
VM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003228:Conjunctiva / Q000601:surgery*; D015353:Eye Enucleation; D017234:Eye Evisceration; D005141:Eyelid Diseases / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009757:Nylons; D020273:Orbital Implants; D011138:Polytetrafluoroethylene; D019919:Prosthesis Implantation; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D015607:Stents; D014945:Wound Healing / Q000502:physiology
D009757:Nylons; D011138:Polytetrafluoroethylene