title: Repair of orbital implant exposure using Müller's muscle flap.
abstract: BACKGROUND
  The purpose of this study is to analyse the 2-stage Müller's muscle flap technique for the treatment of orbital implant exposure and its results.
  
  
  METHODS
  This retrospective study reviewed all patients undergoing surgery using this technique in our university hospital over a 14-year period (1999-2012) in terms of success (no re-exposure of the implant) or failure.
  
  
  RESULTS
  Nineteen patients were managed using this 2-stage procedure. Orbital implant exposure occurred 94.4 months (2-240) after implantation. The success rate was 68.4% (13/19) and failure rate 31.6% (6/19). Risk factors for exposure were enucleation for melanoma followed by radiation therapy, acrylic implant, and early exposure probably due to excessive suture tension.
  
  
  CONCLUSIONS
  Implant exposure is the most common complication after evisceration, enucleation or socket surgery. Several techniques to repair exposures have been described. Two-stage Müller's muscle flap is an interesting option, especially for patients presenting defects larger than 4mm(2) and without previous radiation therapy treatment.
  
  
  CONCLUSIONS
  The two-stage Müller's muscle flap procedure allows for an autologous vascularized pedicle flap from the ipsilateral upper eyelid. It is a reliable technique with a success rate of 68% in our study.
authors.affiliation: Department of ophthalmology, centre hospitalier universitaire Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France. Electronic address: juliettedelmas@wanadoo.fr.
authors.forename: J
authors.initials: J
authors.lastname: Delmas
authors.affiliation: Department of ophthalmology, centre hospitalier universitaire Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Adenis
authors.affiliation: Department of ophthalmology, centre hospitalier universitaire Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France.
authors.forename: P-Y
authors.initials: PY
authors.lastname: Robert
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019882:Blepharoplasty / Q000379:methods*; D002648:Child; D015353:Eye Enucleation; D017234:Eye Evisceration; D005134:Eye Neoplasms / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000601:surgery; D008875:Middle Aged; D020273:Orbital Implants / Q000009:adverse effects; D012175:Retinoblastoma / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D013524:Surgical Flaps; D013536:Suture Techniques / Q000009:adverse effects; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult
keywords: Bille; Cavité; Exposition; Exposure; Flap; Implant; Lambeau; Muscle de Müller; Müller's muscle; Socket