title: Dermis-fat graft for treatment of exposed porous polyethylene implants in pediatric postenucleation retinoblastoma patients.
abstract: OBJECTIVE
  To demonstrate the use of the autogenous dermis-fat graft for the treatment of porous polyethylene implant exposure and volume augmentation in postenucleation retinoblastoma children.
  
  
  METHODS
  Retrospective, interventional case series.
  
  
  METHODS
  Ten children who received a dermis-fat graft at Seoul National University Hospital between July 1, 2005 and January 31, 2010 were included in this study. The patients had undergone unilateral enucleation for retinoblastoma, and received a subconjunctival dermis-fat graft to repair implant exposure and simultaneously correct enophthalmos. The clinical characteristics of the patients, rate of graft survival, and complications were analyzed. The cosmetic outcome was assessed using a grading system.
  
  
  RESULTS
  All patients had enucleation using porous polyethylene implant as a primary orbital implant. The average time to exposure was 89.1 ± 22.4 months and the median size of defect was 2 × 3 mm. With a mean follow-up of 28 months, 9 of 10 patients showed well-survived graft without re-exposure. One patient who experienced a graft failure managed with implant rotation and a scleral graft. Seven patients showed significant improvement of enophthalmos.
  
  
  CONCLUSIONS
  Implantation of an autogenous dermis-fat graft is a procedure that can be effectively used to treat porous polyethylene implant exposure and simultaneously correct enophthalmos. Use of this procedure can be particularly advantageous for pediatric postenucleation patients.
authors.affiliation: Department of Ophthalmology, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Min Joung
authors.initials: MJ
authors.lastname: Lee
authors.forename: Sang In
authors.initials: SI
authors.lastname: Khwarg
authors.forename: Ho-Kyung
authors.initials: HK
authors.lastname: Choung
authors.forename: Nam Ju
authors.initials: NJ
authors.lastname: Kim
authors.forename: Young Suk
authors.initials: YS
authors.lastname: Yu
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D002648:Child; D002675:Child, Preschool; D015353:Eye Enucleation; D005260:Female; D006085:Graft Survival; D006801:Humans; D007223:Infant; D008297:Male; D009915:Orbit / Q000601:surgery*; D020273:Orbital Implants; D020959:Polyethylene; D016062:Porosity; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures; D019572:Retinal Neoplasms / Q000601:surgery; D012175:Retinoblastoma / Q000601:surgery*; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000601:surgery*; D013997:Time Factors; D014182:Transplantation, Autologous
chemical_list: D020959:Polyethylene