Reduce enophthalmos with fat transfer in anophthalmic sockets

To evaluate the efficacy of autologous fat grafting for treating enophthalmos in anophthalmic sockets.

In this prospective interventional case series, consecutive patients with anophthalmic sockets and enophthalmos were enrolled between August 2013 and July 2025. Clinical ophthalmologic examination, Hertel exophthalmometry, and orbital computed tomography scans were performed. Enophthalmos was assessed clinically and radiologically before and after orbital lipofilling with autologous fat. Fat was harvested from the inner thigh and injected into the inferolateral orbital compartment. The volume of injected fat was determined according to the degree of enophthalmos measured by Hertel exophthalmometry. Follow-up ranged from 2 to 60 months (median, 7 months).

Thirteen patients (13 sockets) underwent orbital autologous fat grafting using Coleman's technique. The injected fat volume ranged from 3.7 to 6 mL per procedure (median, 4.2 mL). Clinically, a reduction in enophthalmos of 1-5 mm was observed in 12 cases (median, 2 mm), which was associated with a decrease in prosthesis thickness. One patient developed a fat cyst due to anterior fat migration, and three patients required repeat grafting because of undercorrection. Computed tomography scans, available for nine patients, demonstrated a 6.8%-10.8% increase in intraorbital volume, particularly in the inferolateral quadrant.

Clinical and radiological assessments demonstrated that lipofilling is an effective technique for restoring orbital volume in anophthalmic sockets with enophthalmos.