title: Comparative analysis of use of porous orbital implant with mucus membrane graft and dermis fat graft as a primary procedure in reconstruction of severely contracted socket.
abstract: OBJECTIVE
  The purpose of our study is to present a surgical technique of primary porous orbital ball implantation with overlying mucus membrane graft (MMG) for reconstruction of severely contracted socket and to evaluate prosthesis retention and motility in comparison to dermis fat graft (DFG).
  
  
  METHODS
  Prospective comparative study.
  
  
  METHODS
  A total of 24 patients of severe socket contracture (Grade 2-4 Krishna's classification) were subdivided into two groups, 12 patients in each group. In Group I, DFG have been used for reconstruction. In Group II, porous polyethylene implant with MMG has been used as a primary procedure for socket reconstruction. In Group I DFG was carried out in usual procedure. In case of Group II, vascularized scar tissues were separated 360° and were fashioned into four strips. A scleral capped porous polyethylene implant was placed in the intraconal space and four strips of scar tissue were secured to the scleral cap and extended part overlapped the implant to make a twofold barrier between the implant and MMG. Patients were followed-up as per prefixed proforma. Prosthesis motility and retention between the two groups were measured.
  
  
  RESULTS
  In Group I, four patients had recurrence of contracture with fall out of prosthesis. In Group II stable reconstruction was achieved in all the patients. In terms of prosthesis motility, maximum in Group I was 39.2% and Group II, was 59.3%. The difference in prosthesis retention (P = 0.001) and motility (P = 0.004) between the two groups was significant.
  
  
  CONCLUSIONS
  Primary socket reconstruction with porous orbital implant and MMG for severe socket contracture is an effective method in terms of prosthesis motility and prosthesis retention.
authors.affiliation: Department of Orbit, Ophthalmic Plastic and Reconstructive Surgery, Sri Sankaradeva Nethralaya, Beltola, Guwahati, Assam, India.
authors.forename: Kasturi
authors.initials: K
authors.lastname: Bhattacharjee
authors.forename: Harsha
authors.initials: H
authors.lastname: Bhattacharjee
authors.forename: Ganesh
authors.initials: G
authors.lastname: Kuri
authors.forename: Jayanta Kr
authors.initials: JK
authors.lastname: Das
authors.forename: Debleena
authors.initials: D
authors.lastname: Dey
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000293:Adolescent; D000328:Adult; D002648:Child; D003286:Contracture / Q000601:surgery*; D020405:Dermis / Q000637:transplantation*; D017234:Eye Evisceration; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000637:transplantation*; D009916:Orbital Diseases / Q000601:surgery*; D020273:Orbital Implants; D016062:Porosity; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult