title: Serial reconstruction of anophthalmic orbits with 'bag-shaped' flaps.
abstract: BACKGROUND
  The author's goal was to present an approach for serial surgical reconstruction of anophthalmic orbits with 'bag-shaped' flaps and cartilage transplantation.
  
  
  METHODS
  A review was performed of 53 patients who underwent serial physiological orbital reconstruction between 2006 and 2013. Orbital reconstruction was performed serially in stages, including "bag-shaped" flap transplantation, medial and lateral canthoplasty, tarsus reconstruction, and improvement of the strength of the levator palpebrae superior muscles. Curative effects were evaluated by the surgeons and patients jointly.
  
  
  RESULTS
  Among the total of 53 cases, the curative effects were assessed as excellent in 28 patients, good in 17 patients, moderate in 6 patients, and poor in 2 patients. Two cases suffered necrosis of the bag-shaped flap, which was remedied with a frontal island flap and skin grafting; 4 cases experienced shallowness of the lower fornix, of which three were remedied by deepening of the lower fornix and the other by lower eyelid suspension. The appearance of the reconstructed eye socket was acceptable, natural and persistent.
  
  
  CONCLUSIONS
  This procedure offers staged and serial reconstruction of anophthalmic orbits, according to the orbital shape and the volume loss of the orbital soft tissue. It is an ideal approach to reconstruct eye sockets, with a high survival rate of the flaps, acceptable appearance of the reconstructed eye socket, and stable depth of the upper and lower eyelid fornices.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai 200011, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai 200011, China.
authors.forename: Liying
authors.initials: L
authors.lastname: Cheng
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai 200011, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Jin
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai 200011, China.
authors.forename: Yaoming
authors.initials: Y
authors.lastname: Shi
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai 200011, China.
authors.forename: Baoshan
authors.initials: B
authors.lastname: Sun
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai 200011, China.
authors.forename: Zuoliang
authors.initials: Z
authors.lastname: Qi
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai 200011, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai 200011, China. Electronic address: luzhangmd@gmail.com.
authors.forename: Yuguang
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000853:Anophthalmos / Q000601:surgery*; D002356:Cartilage / Q000637:transplantation; D004954:Esthetics; D005137:Eye, Artificial; D005143:Eyelids / Q000601:surgery; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000000981:diagnostic imaging / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Anophthalmic orbit; Eye socket defect; Orbit reconstruction; ‘Bag-shape’ dorsalis pedis flap