Outcomes of Autogenous Dermis Fat Grafting with Different Donor Sites in Exposed Porous Orbital Implants

Young Hoon Yang; Ahn Min

doi:10.3341/jkos.2013.54.4.545

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Yang and Min: Outcomes of Autogenous Dermis Fat Grafting with Different Donor Sites in Exposed Porous Orbital Implants

Original Article

J Korean Ophthalmol Soc 2007;54(4):545-551.

Published online: 24 August 2007

DOI: https://doi.org/10.3341/jkos.2013.54.4.545

Outcomes of Autogenous Dermis Fat Grafting with Different Donor Sites in Exposed Porous Orbital Implants

Young Hoon Yang, MD, Ahn Min, MD, PhD

Department of Ophthalmology, Chonbuk National University Medical School, Jeonju, Korea

Address reprint requests to Min Ahn, MD, PhD Department of Ophthalmology, Chonbuk National University Hospital #567 Baekje-daero, Deokjin-gu, Jeonju-si, Jellabuk-do 565-756, Republic of Korea Tel: 82-63-250-1996, Fax: 82-63-250-1960, E-mail: ahnmin@jbnu.ac.kr

Received 3 August 201211 September 2012 Accepted 13 March 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare the outcomes of autogenous dermis fat grafting with different donor sites in the treatment of exposed porous orbital implants.

Methods

The present study retrospectively evaluated the medical records of 17 patients (17 anophthalmic eyes) who had undergone autogenous dermis fat grafting based on the diagnosis of exposed porous orbital implants and were regularly followed up for at least 12 months since the surgery from January 2001 to December 2010. The patients were divided into 2 groups (thigh and abdomen) according to the site of the donor grafting. The treatment outcome and complications were compared between the 2 groups.

Results

The success rate of thigh dermis fat grafting was 88.9% (8/9) and 100.0% (8/8) in the abdominal dermis fat grafting, and there was no statistically significant difference between the 2 groups (p = 1.000). Regarding ocular complications, graft tissue infection (thigh 11.1%, abdomen 0%) and superior sulcus deformity (thigh 22.2%, abdomen 25.0%) were present. Regarding donor site complications, tenderness (thigh 55.6%, abdomen 25.0%), dehiscence (thigh 22.2%, abdomen 25.0%) and scar formation (thigh 33.3%, abdomen 25.0%) were observed. In the gait associated complications, pain (thigh 55.6%, abdomen 25.0%) and limping (thigh 22.2%, abdomen 12.5%) were observed. The rate of all complications showed no statistically significant difference between the thigh dermis fat grafting and the abdominal dermis fat grafting (all p > 0.05).

Conclusions

Thigh and abdomen can both be considered as an effective donor site for the autogenous dermis fat grafting in the treatment of exposed porous orbital implants.

Keywords: Dermis fat graft, Donor site, Exposed porous orbital implant

References

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Figure 1.

(A) Preoperative photograph of an exposed porous orbital implant at a 54-year-old male. (B) Post-operative (1 week after dermis fat graft) photograph. (C) Post-operative (1 month after dermis fat graft) photograph. (D) At post-operative 6 months after dermis fat graft, no evidence of re-exposure is observed.

Table 1.

Clinical data of 17 patients with exposure of implant

Case	Age/Sex	Diagnosis	Surgery	Implant	Exposure size	Donor site	Healing period (week)	F/U period (month)	Result
1	20/M	Eyeball rupture	Enucleation	HAP	Large*	Thigh	6	18	No exposure
2	70/M	Phthisis bulbi	Evisceration	HAP	Large	Thigh	8	27	No exposure
3	50/M	Phthisis bulbi	Evisceration	HAP	Large	Thigh	8	12	No exposure
4	42/M	Eyeball rupture	Enucleation	HAP	Large	Thigh	6	13	No exposure
5	30/F	Eyeball rupture	Enucleation	HAP	Large	Thigh	5	14	No exposure
6	58/F	Phthisis bulbi	Evisceration	Medpor^®	Large	Thigh	8	21	No exposure
7	60/M	Phthisis bulbi	Evisceration	Medpor^®	Large	Thigh	.	36	Graft failure
8	71/F	Eyeball rupture	Enucleation	Medpor^®	Large	Thigh	9	20	No exposure
9	54/M	Eyeball rupture	Enucleation	Medpor^®	Large	Thigh	8	12	No exposure
10	60/M	Phthisis bulbi	Evisceration	HAP	Large	Abdomen	6	9	No exposure
11	24/M	Eyeball rupture	Enucleation	HAP	Large	Abdomen	7	14	No exposure
12	42/M	Eyeball rupture	Enucleation	HAP	Large	Abdomen	10	36	No exposure
13	76/M	Phthisis bulbi	Evisceration	Medpor^®	Large	Abdomen	10	17	No exposure
14	51/F	Eyeball rupture	Enucleation	Medpor^®	Large	Abdomen	9	12	No exposure
15	75/M	Eyeball rupture	Enucleation	Medpor^®	Large	Abdomen	9	41	No exposure
16	24/M	Phthisis bulbi	Evisceration	Medpor^®	Large	Abdomen	6	24	No exposure
17	69/M	Eyeball rupture	Enucleation	Medpor^®	Large	Abdomen	6	12	No exposure

HAP = hydroxyapatite.

^* Large: exposure size > 10 mm2; Small: exposure size < 10 mm2.

Table 2.

Comparison of clinical data of 17 patients with exposure of implant divided by donor sites

	Thigh (n = 9)	Abdomen (n = 8)	p-value
Mean age (years)	54.4 ± 17.3	52.6 ± 21.1	0.827*
Sex (M:F)	6:3	7:1	0.577^†
Diagnosis (Phthisis:Rupture)	4:5	3:5	1.000^†
Sugery (Enucleation:Evisceration)	5:4	5:3	1.000^†
Implant (Hydroxyapatite:Medpor^®)	5:4	3:5	0.637^†
Exposure size (Large:Small)	9:0	8:0	1.000^†

^* Unpaired t-test

^† Fisher's exact test.

Table 3.

Comparison of complications of 17 patients with exposure of implant divided by donor sites

	Thigh (n = 9)	Abdomen (n = 8)	p-value*
Ocular complications
Superior sulcus deformity	2/9 (22.2%)	2/8 (25.0%)	1.000
Graft infection	1/9 (11.1%)	0/8 (0.0%)	1.000
Donor site complications
Tenderness	5/9 (55.6%)	2/8 (25.0%)	0.335
Wound dehiscence	2/9 (22.2%)	2/8 (25.0%)	0.471
Significant scarring	3/9 (33.3%)	1/8 (12.5%)	0.577
Gait complications
Pain	5/9 (55.6%)	2/8 (25.0%)	0.335
Limping	2/9 (22.2%)	0/8 (0.0%)	0.577

^* Fisher's exact test.

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