Autologous pericranium grafts for large orbital implants

Insufficient orbital volume in an anophthalmic socket is a major problem for the placement of an ocular prosthesis. This study reports the outcomes of the use of autologous pericranium graft in association with a large primary or secondary orbital implant in patients with a contracted socket and large orbital volume deficit.

This was a retrospective single-institution study. Participants were 13 patients with contracted socket, volume deficit, and insufficient conjunctiva to cover the new implant divided into two groups, A (n = 3) and B (n = 10), according to the baseline condition of the socket. Surgery was primary evisceration (group A only) and placement of a large orbital implant followed by an autologous pericranium graft over the implant (groups A and B).

Mean follow-up duration for the patient series was 9.5 months (range 9-24). Complete epithelialization of the pericranium graft was recorded at 47.3 days of follow-up (range 33-67). No cases of implant exposure or shrinkage were noted during follow-up. Main postoperative complications were conjunctival granuloma (five patients, 38.5%), conjunctival seroma (one patient, 7.7%). All patients were satisfied with the aesthetic outcome.

Autologous pericranial graft was effective in reconstructing the contracted socket so that the anophthalmic socket could accommodate a larger or secondary orbital implant. The efficacy of this procedure needs to be confirmed in a larger patient series.