Klinger Francesco, Maione Luca, Vinci Valeriano, Lisa Andrea, Barbera Federico, Balia Laura, Caviggioli Fabio, Di Maria Alessandra
a Reconstructive and Aesthetic Plastic Surgery School-MultiMedica Holding S.p.A.- Plastic Surgery Unit-Sesto San Giovanni , University of Milan , Milan , Italy.
b Department of Medical Biotechnology and Translational Medicine BIOMETRA-Plastic Surgery Unit, Humanitas Research Hospital , University of Milan, Reconstructive and Aesthetic Plastic Surgery School , Milan , Rozzano , Italy.
Orbit. 2018 Oct;37(5):344-347. doi: 10.1080/01676830.2017.1423358. Epub 2018 Jan 5.
Autologous fat grafting has been extensively and successfully adopted in a number of pathologic conditions in regenerative surgery especially on irradiated fields in order to improve pain symptoms and tissue trophism promoting scar release. In the present study, we report our experience with autologous fat grafting for the treatment of postirradiation fibrosis and pain on three consecutive patients undergoing orbital enucleation for locally advanced retinoblastoma (RB) and subsequent radiotherapy. We selected three consecutive patients who underwent orbital enucleation for locally advanced RB and subsequent local radiotherapy showing severe reduction in orbital volume and eyelid length and retraction due to fibrosis, spontaneous local pain exacerbated after digital pressure with no possibility to place an ocular implant. They underwent autologous fat grafting in the orbital cavity and results were evaluated by clinical examination at 5 and 14 days, and 1, 3, 6 months, and 1 year after surgery. A significant release of scar retraction, reduction of fibrosis and orbital rim contraction together with an important improvement of pain symptoms was observed in all patients. The local changes observed enabled an ease placement of an ocular prosthetic implant (implant). No local or systemic complication occurred. Fat grafting is a promising treatment for patients showing radiotherapy related complication in the orbital area and it should be adopted by all oculoplastic surgeon in order to improve pain syndrome creating the ideal local conditions for the placement of an ocular prosthetic implant.
自体脂肪移植已被广泛且成功地应用于再生外科的多种病理状况，尤其是在放疗区域，以改善疼痛症状和组织营养状况，促进瘢痕松解。在本研究中，我们报告了对三名因局部晚期视网膜母细胞瘤（RB）接受眼眶摘除术及后续放疗的患者进行自体脂肪移植治疗放疗后纤维化和疼痛的经验。我们选择了三名连续的患者，他们因局部晚期RB接受了眼眶摘除术及后续局部放疗，由于纤维化导致眼眶容积和眼睑长度严重减小以及退缩，手指按压后自发局部疼痛加剧，无法植入眼内假体。他们在眼眶腔内接受了自体脂肪移植，并在术后5天、14天、1个月、3个月、6个月和1年通过临床检查评估结果。所有患者均观察到瘢痕退缩明显松解、纤维化和眶缘收缩减轻，同时疼痛症状有显著改善。观察到的局部变化使眼假体植入（义眼）变得容易。未发生局部或全身并发症。对于眼眶区域出现放疗相关并发症的患者，脂肪移植是一种有前景的治疗方法，所有眼整形医生都应采用，以改善疼痛综合征，为眼假体植入创造理想的局部条件。
