Dermis-fat grafts and evisceration.

Area of Science:

• Ophthalmic reconstructive surgery
• Orbital implantology
• Ocular prosthetics

Background:

• Dermis-fat grafts (DFGs) are established for orbital reconstruction after enucleation.
• Current applications include managing implant issues, socket contracture, and enophthalmos.
• Phthisis bulbi presents reconstructive challenges, often necessitating enucleation.

Observation:

• This study introduces a novel application of DFGs with evisceration for phthisical globes.
• The technique can be performed primarily or secondarily.
• Evisceration offers potential cosmetic and motility advantages over enucleation.

Findings:

• Dermis-fat grafting combined with evisceration is a viable alternative to enucleation for phthisical globes.
• This combined approach effectively addresses enophthalmos associated with phthisis.
• Improved cosmesis and ocular motility were observed.

Implications:

• Reduces the need for enucleation in select cases of phthisis bulbi.
• Enhances aesthetic and functional outcomes in orbital reconstruction.
• Expands the reconstructive toolkit for ophthalmic surgeons managing complex ocular conditions.