Orbital volume augmentation with autologous micro-fat grafts

The purpose of this study is to present an alternative procedure for rehabilitation of the volume deficient anophthalmic or enophthalmic socket.

A retrospective review of clinical and photographic records of 12 patients with either an anophthalmic or enophthalmic orbit (14 orbits) undergoing volume augmentation by micro-fat grafting, or lipostructure, as initially described by Coleman. Patients with orbital volume deficiency seen in the oculoplastic clinic at Chelsea and Westminster Hospital, London, UK, were invited to participate in the study. The technique is discussed in detail.

The volume of fat injected ranged from 0.8 mL to 4.5 mL (median, 3.05 mL) per orbit, with a median increase in exophthalmometry measurements (available in 9 patients) of 2 mm (range, 0-7.5 mm). Subjective improvement in cosmetic outcome was experienced in all patients. Repeat grafting was required in 1 patient, and will be required in another patient. There were no embolic complications. The procedure was well tolerated in all patients. Median follow-up was 14.5 months (range,12-30 months).

Micro-fat grafting to the anophthalmic or enophthalmic socket appears to be a safe alternative technique for orbital volume enhancement. It has the advantages of avoiding alloplastic infectious complications, ease of technique, minimal donor site morbidity, acceptable graft take rate, low embolic complication rate, and good cosmetic outcome.