Kuzmanović Elabjer Biljana, Busić Mladen, Bosnar Damir, Elabjer Esmat, Miletić Daliborka
University Eye Clinic, University Hospital "Sveti Duh", Zagreb, Croatia.
Orbit. 2010 Aug;29(4):209-12. doi: 10.3109/01676830.2010.485716.
To present our experience with dermofat graft in reconstruction of anophthalmic socket.
In period from September 2005 until June 2009, eight patients have undergone orbital surgery of transplantation of dermofat graft. In six patients the dermofat graft was used as the secondary orbital implant after extrusion of hydroxyapatite orbital implant with major defect of bulbar conjunctiva. The other indication for the dermofat graft was correction of deep superior sulcus of the upper lid in anophthalmic socket in two patients. The graft was harvested from the left side of the belly. The size of the graft purposely exceeded the size of the defect to account for the expected tissue resorption.
We experienced no major complication. Approximately 20-40% of dermofat graft reduction was noticed in 3-months period postoperatively. It took 6-8 weeks for the graft to fully epithelize from the conjunctival edge. Silicone conformer was introduced for that period of time. Subsequently, in two out of six patients with dermofat graft as the secondary implant, fornix had to be reconstructed later on with oral mucosa graft.
Dermofat graft is a valuable material in orbital reconstruction especially in anophthalmic socket.
介绍我们使用真皮脂肪移植修复无眼球眼眶的经验。
2005年9月至2009年6月期间,8例患者接受了真皮脂肪移植眼眶手术。6例患者在羟基磷灰石眼眶植入物脱出且球结膜存在较大缺损后,将真皮脂肪移植用作二期眼眶植入物。真皮脂肪移植的另一个适应证是矫正2例无眼球眼眶上睑的深部上睑沟。移植组织取自腹部左侧。移植组织的大小特意超过缺损大小,以考虑到预期的组织吸收。
我们未遇到重大并发症。术后3个月观察到真皮脂肪移植组织大约减少了20% - 40%。移植组织从结膜边缘完全上皮化需要6 - 8周。在此期间引入了硅胶贴合器。随后,在6例将真皮脂肪移植用作二期植入物的患者中,有2例后来不得不使用口腔黏膜移植来重建穹窿。
真皮脂肪移植是眼眶重建尤其是无眼球眼眶重建中的一种有价值的材料。