[Dermal fatty tissue transplant as primary and secondary orbital implant. Complications and results]

In this retrospective study we report the indications, complications and functional and cosmetic results after dermofat grafting into anophthalmic orbits. The method consists of implantation of autogenous dermis with attached subcutaneous fat from the gluteal region into the orbit. Twenty-four primary and 4 secondary grafts were implanted in 28 patients aged 12 to 49 years. In the explantation site one patient showed delayed healing. All implants became integrated, none were lost because of infection or extrusion. Eleven patients developed minor complications like central ulceration in the dermis, hair growth on the dermis or suture granuloma. In the primary implant group the functional and cosmetic outcome was evaluated by measurements of the lid structures, exophthalmometry (Hertel) and measuring the prosthesis motility (Kestenbaum). Three patients showed fair results; all the others had good or very good results. In one case of a secondary implant marked graft atrophy was observed. Despite the more extensive surgery and some minor complications the safety of this method with good functional and cosmetic results makes dermofat grafting an excellent alternative to heterogeneous orbital implants.