title: Surgical outcomes of acellular human dermal grafts for large conjunctiva defects in orbital implant insertion.
abstract: OBJECTIVE
  We report the surgical outcomes of acellular human dermal allografts for repair of large conjunctiva defects in primary or secondary orbital implant insertion.
  
  
  METHODS
  This retrospective chart review examined 12 eyes in 12 patients who underwent primary or secondary orbital implant insertion using Medpor® and acellular human dermal allografts to decrease conjunctival tension. Only patients with at least 6 months follow-up were included. The procedure was successful if there was no exposure until the last eye-clinic visit and the patient could wear a prosthesis. It failed if additional surgery was needed to correct the orbital implant exposure.
  
  
  RESULTS
  The mean follow-up was 24.5 (range 6-54) months. Seven patients had primary orbital implant insertion, and five had secondary orbital implant insertion with acellular human dermal allografts. All enrolled patients had successful outcomes without exposure of the central conjunctiva. Two underwent additional surgery to correct fornix contracture and regain a cosmetically good prosthesis. Of these, one patient received additional acellular human dermal grafts and had a fair outcome. The other patient ultimately required fornix reconstruction with an autologous graft using oral mucosa.
  
  
  CONCLUSIONS
  Orbital implant insertion with acellular human dermis grafts had good surgical outcomes. The procedure could be effective for patients with insufficient conjunctival tissue to cover an orbital implant and a high probability of developing orbital implant exposure if tension was created by excessive direct conjunctival closure.
authors.affiliation: Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #505 Banpo-dong, Seocho-gu, Seoul, 137-701, South Korea.
authors.forename: Su-Kyung
authors.initials: SK
authors.lastname: Jung
authors.forename: Ji-Sun
authors.initials: JS
authors.lastname: Paik
authors.forename: Uk-Hyun
authors.initials: UH
authors.lastname: Sonn
authors.forename: Suk-Woo
authors.initials: SW
authors.lastname: Yang
mesh_terms: D062088:Acellular Dermis; D000328:Adult; D000368:Aged; D064591:Allografts; D001672:Biocompatible Materials; D003094:Collagen; D003229:Conjunctival Diseases / Q000601:surgery*; D017234:Eye Evisceration; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020273:Orbital Implants; D011095:Polyethylenes; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D016038:Skin Transplantation; D013536:Suture Techniques; D016896:Treatment Outcome
chemical_list: C440568:Alloderm; D001672:Biocompatible Materials; C084562:Medpor; D011095:Polyethylenes; D003094:Collagen