title: Dermis-fat grafts and enucleation in Ghanaian children: 5 years' experience.
abstract: BACKGROUND
  Enucleation in young children often results in retarded orbital growth ipsilaterally. The need for an implant that will naturally grow with the child, like Dermis-fat Graft (DFG), for managing the anophthalmia has been of interest over the years.
  
  
  OBJECTIVE
  To evaluate the use of DFG as an implant for volume replacement post-enucleation.
  
  
  METHODS
  A prospective non-comparative case series involving 18 consecutive children who had DFG either primarily or secondarily in conjunction with enucleation for intraocular pathologies, from December 2007 to September 2012, at the ophthalmology unit, Korle-Bu. Data from patients who had a minimum of three months follow up(FUP) were analysed.
  
  
  METHODS
  Complete covering of DFG with healthy conjunctiva, increase in volume of DFG, and presence or absence of complications.
  
  
  RESULTS
  Fifteen patients were analysed, aged nine months to ten years (mean (SD), 3.7±2.7years). Eight (53.3%) were females. Thirteen (86.7%) DFGs were secondary and 2(13.3%) primary. Indications for enucleation were intraocular retinoblastoma (n=10, 66.7%), unexplained retinal detachment mimicking retinoblastoma (n=3,20.0%), anterior staphyloma (n=1,6.7%) and medulloepithelioma (n=1,6.7%). Fourteen (93.3%) patients showed increase in volume of DFG. Time for Conjunctival reepithelialisation of the dermal surface was four to fourteen weeks (mean/median=5.5/4.0). Complications encountered were infection (n=1,6.7%), infection with necrosis (n=1,6.7%), melanosis /keratinization (n=2, 13.3%) and cysts(n=2,13.3%). The patients were followed up for 3 to 54 months (mean/median 20.13 /16.00).
  
  
  CONCLUSIONS
  DFG for management of post-enucleation anophthalmia in Ghanaian children showed 93.3% success.
authors.affiliation: Ophthalmology Unit, Department of Surgery, University of Ghana Medical School, Korle-Bu.
authors.forename: V A
authors.initials: VA
authors.lastname: Essuman
authors.affiliation: Ophthalmology Unit, Department of Surgery, Korle-Bu Teaching Hospital, Korle-Bu.
authors.forename: N N
authors.initials: NN
authors.lastname: Tagoe
authors.affiliation: University of Ghana Dental School, Korle-Bu.
authors.forename: T A
authors.initials: TA
authors.lastname: Ndanu
authors.affiliation: Ophthalmology Unit, Department of Surgery, University of Ghana Medical School, Korle-Bu.
authors.forename: C T
authors.initials: CT
authors.lastname: Ntim-Amponsah
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D002648:Child; D002675:Child, Preschool; D003228:Conjunctiva / Q000502:physiology; D003560:Cysts / Q000209:etiology; D015353:Eye Enucleation; D005134:Eye Neoplasms / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005869:Ghana; D006801:Humans; D007223:Infant; D007239:Infections / Q000209:etiology; D008297:Male; D009336:Necrosis / Q000209:etiology; D018242:Neuroectodermal Tumors, Primitive / Q000601:surgery*; D009915:Orbit / Q000254:growth & development; D011183:Postoperative Complications / Q000209:etiology*; D062326:Re-Epithelialization; D012175:Retinoblastoma / Q000601:surgery*; D016038:Skin Transplantation
keywords: Dermis- fat graft; anophthalmia; enucleation; volume replacement