Abstract
Purpose
This study is executed to identify and report the treatment effects of oral mucosa grafting of prosthetic eye patients who have shallow conjunctival socket caused by socket contraction.
Methods
Conjunctival sac reconstruction was performed by using the lower lip mucosa to 11 eyes of 11 patients diagnosed with contracted conjunctival sac at the ophthalmic clinic from August 2009 to May 2015, and a retrospective analysis was performed with medical record data from the patients who were followed-up after surgery.
Results
Within the follow-up period, prosthetic eye insertion was possible for all 11 eyes of the 11 patients. All of them were satisfied in an aesthetic aspect, and were able to maintain deep conjunctival sac without receving findings of graft absorption, or re-contracted or shallow conjunctival sac during the follow-up period. On the donor region, normal epithelialization occurred. Concerning the donor region for the first week after surgery, the mean score of the patients' pain was 3.18 ± 0.94 points measured by a numerical rating scale, and no infection, bleeding, contraction, or cicatrix was revealed during the follow-up period. There were hypoesthesia, pararthria, and paresthesia (tingling sense) for post-complications from the donor region, and four patients out of the 11 patients complained of discomfort resulting from post-complications; whereas the remaining seven patients did not complain of discomfort.
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Figure 1.
Pre- and postoperative photo. (A) Postoperative photograph taken 11 days after the operation, conjunctival fornix reconstruction, upper. (B) Postoperative photograph taken 11 days after the operation, conjunctival fornix reconstruction, lower.
![jkos-57-188f1.tif](/upload/SynapseXML/0035jkos/thumb/jkos-57-188f1.gif)
Figure 2.
Lower lip donor site. (A) Preoperative photograph. (B) Intraoperative photograph. (C) Postoperative photograph taken 4 days after the operation. (D) Postoperative photograph taken 11 days after the operation.
![jkos-57-188f2.tif](/upload/SynapseXML/0035jkos/thumb/jkos-57-188f2.gif)
Table 1.
Grading of conjunctival socket contraction
Table 2.
Summary of patients
Table 3.
Summary of 11 operations, conjunctival sac reconstruction
Table 4.
Complications of donor site
No. | Observation time (years) | NRS | Time to epithelization (weeks) | Answer* | Late phase complication |
---|---|---|---|---|---|
1 | 1 | 3 | 4 | No | Hypoesthesia |
2 | 5 | 3 | 3 | Yes | - |
3 | 4 | 2 | 3 | Yes | Hypoesthesia |
4 | 5 | 2 | 2 | Yes | - |
5 | 5 | 5 | 3 | No | - |
6 | 5 | 3 | 3 | Yes | Hypoesthesia, tingling sensation |
7 | 5 | 3 | 2 | Yes | - |
8 | 5 | 3 | 3 | Yes | - |
9 | 4 | 3 | 3 | Yes | - |
10 | 1 | 3 | 3 | Yes | - |
11 | 2/12 | 5 | 5 | No | Hypoesthesia, numbness |