Dermis fat grafts as primary and secondary orbital implants

This study was performed to evaluate the outcome after autologous dermis-fat graft [DFG] orbital implants in a large sample.

A retrospective chart review of all primary and secondary DFGs in a 16-year period was done. Aesthetic and functional results, patients' satisfaction and postoperative complications were evaluated.

In total 468 DFGs were performed in the study period (315 primary [I°] and 153 secondary [II°] DGFs). In the analysis, 173 DFG I° and 66 DFG II° were included as sufficient follow-up was available. Median follow-up after DFG I° was 21.5 months and 14 months after DFG II°. After DFG I°, in 76% of patients motility of the graft was possible in all directions; 81% had good fitting of the prosthesis and 83% were highly satisfied with the results. Mean width of palpebral apertures was 0.2 mm smaller and Hertel exophthalmometry revealed a mean enophthalmus of 1.6 mm on the operated side compared to the fellow-eye. After DFG II°, motility was possible in all directions in 34% of patients. Fitting of the prosthesis was good/reasonable in 49%/41% and patients were highly satisfied in 57%. On average, on the operated side palpebral apertures were 0.6 mm smaller and Hertel measurements showed an enophthalmus of 2.6 mm. Major complications were uncommon. Complete necrosis of the implant was more often observed after II° (6.1%) than after I° DFG (3.5%).

In this large sample, DFG proved to be an effective and safe method for the reconstruction of anophthalmic sockets.