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Updated: Apr 23, 2026
Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
Published on: December 5, 2025
Repair of orbital implant exposure using Müller's muscle flap
J Delmas1, J-P Adenis1, P-Y Robert1
1Department of ophthalmology, centre hospitalier universitaire Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France.
Introduction:
The purpose of this study is to analyse the 2-stage Müller's muscle flap technique for the treatment of orbital implant exposure and its results.
Materials And Methods:
This retrospective study reviewed all patients undergoing surgery using this technique in our university hospital over a 14-year period (1999-2012) in terms of success (no re-exposure of the implant) or failure.
Results:
Nineteen patients were managed using this 2-stage procedure. Orbital implant exposure occurred 94.4 months (2-240) after implantation. The success rate was 68.4% (13/19) and failure rate 31.6% (6/19). Risk factors for exposure were enucleation for melanoma followed by radiation therapy, acrylic implant, and early exposure probably due to excessive suture tension.
Discussion:
Implant exposure is the most common complication after evisceration, enucleation or socket surgery. Several techniques to repair exposures have been described. Two-stage Müller's muscle flap is an interesting option, especially for patients presenting defects larger than 4mm(2) and without previous radiation therapy treatment.
Conclusion:
The two-stage Müller's muscle flap procedure allows for an autologous vascularized pedicle flap from the ipsilateral upper eyelid. It is a reliable technique with a success rate of 68% in our study.
