Exposed Porous Orbital Implants Treated With Simultaneous Secondary Implant and Dermis Fat Graft

Abstract

PURPOSE: To describe a technique for simultaneous secondary orbital implantation and dermis fat graft placement for exposed porous implants with significant conjunctival insufficiency. DESIGN: Retrospective review of 4 consecutive cases. METHODS: Charts were reviewed for type and size of exposed porous implant, size of conjunctival defect, history of previous reconstruction for exposure, size and type of implant placed, follow-up interval, complications, ability to retain prosthesis, and cosmesis. RESULTS: Four patients underwent simultaneous dermis fat graft placement and secondary implantation for exposed and completely avascular orbital implants. The rectus muscles were advanced over the new implant to act as the host bed for the dermis fat graft. All patients tolerated a new prosthesis well, with adequate motility and cosmesis. CONCLUSIONS: Simultaneous secondary implantation and dermis fat graft placement may adequately address avascular porous implant exposure with significant conjunctival insufficiency.