Reconstruction of the partially contracted ocular socket or fornix

Foreshortening of the conjunctival fornices by symblepharon or scar formation can result in a variety of cosmetic and functional abnormalities for the anophthalmic and the sighted patient. To correct this problem, we have modified a technique for the treatment of totally contracted ocular sockets. Unlike the procedure for total reconstruction of the socket that uses a custom-designed conformer wrapped with a full-thickness mucous membrane graft, reconstruction of a partially contracted socket uses a 0.5-mm-thick mucous membrane graft sutured to the resected socket conjunctiva and splinted in place by a custom-designed conformer. Seventeen patients with a variety of underlying pathologic conditions associated with trauma and prior surgery underwent successful ocular fornix reconstruction using this technique.