title: Dermis-Fat Graft in Children as Primary and Secondary Orbital Implant.
abstract: OBJECTIVE
  To report the experience with the use of dermis-fat graft in the pediatric population and to evaluate the outcome of this procedure as a primary or secondary orbital implant.
  
  
  METHODS
  Case series. Analysis of the clinical charts of 22 patients. Age at the time of surgery ranged from 2.1 to 13 years. Three patients affected were submitted to evisceration with primary dermis-fat graft. Six patients had explantation of exposed implants and a replacement with a dermis-fat graft. Three patients had a dermis-fat graft to repair contracted sockets. Ten patients were affected by congenital anophthalmia: 4 patients had a primary dermis-fat graft, 6 patients had a removal of a socket expander, or an orbital spherical expander, or pellet expanders and a replacement with a dermis-fat graft. This study adheres to the principles outlined in the Declaration of Helsinki.
  
  
  RESULTS
  The patients' follow up ranged between 2.5 and 8 years. Only 1 child who had a primary dermis-fat graft experienced excessive growth of the implant, managed by surgical debulking. In the end, all the patients showed satisfactory orbital volume along with adequate fornices.
  
  
  CONCLUSIONS
  The dermis-fat graft as a primary implant may be useful in children with severe scleromalacia or following ocular trauma. It is a suitable option in children affected by congenital anophthalmia as it helps continued socket expansion. It can also be considered in the pediatric population to address the volume deficit following explantation of exposed implants and in contracted sockets.
authors: Orbital and Adnexal Service, Department of Ophthalmology, Villa Tiberia Hospital, Rome, Italy.
authors: Francesco M
authors: FM
authors: Quaranta-Leoni
authors: Sabrina
authors: S
authors: Sposato
authors: Pietro
authors: P
authors: Raglione
authors: Angelo
authors: A
authors: Mastromarino
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000293:Adolescent; D000853:Anophthalmos / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D020405:Dermis / Q000637:transplantation*; D020878:Device Removal; D017234:Eye Evisceration; D005260:Female; D006801:Humans; D008297:Male; D020273:Orbital Implants; D019919:Prosthesis Implantation / Q000379:methods*