Dermis fat graft in eviscerated sockets.

Following evisceration, three patients who experienced extrusion of synthetic orbital implant underwent socket reconstruction using an autogenous dermis fat graft. An incision into the fundus of the existing sclera was necessary to provide for an adequate vascular bed for a composite fat graft, although the anterior ring of existing sclera with extraocular muscle attachments was not disturbed. Conjunctival reepithelialization of the dermal surface and enhancement of orbital volume occurred in each case. Furthermore, the autogenous fat graft retained the original excellent globe motility that was present before the socket reconstruction. After an average follow-up of 18 months, the volume restoration, integrity of conjunctival epithelium and fornices, and the graft viability have remained unchanged. As with alloplastic orbital implant extrusions in enucleated sockets, autogeneous dermis fat grafts can be useful in managing extrusions in previously eviscerated sockets.