Single-Stage Orbital Socket Reconstruction Using the Oversized Dermis Fat Graft and the 22 mm Silicone Orbital Implant after an Extended Enucleation

We would like to present a surgical technique of orbital socket reconstruction using oversized dermis fat graft and 22 mm silicone orbital implant in a single-stage after extended enucleation in two patients with massive local recurrence of anteriorly located choroidal melanoma previously treated wi...

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Main Authors: Biljana Kuzmanović Elabjer, Mladen Bušić, Daliborka Miletić, Mirjana Bjeloš, Borna Šarić, Damir Bosnar
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Case Reports in Ophthalmological Medicine
Online Access:http://dx.doi.org/10.1155/2018/8954193
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author Biljana Kuzmanović Elabjer
Mladen Bušić
Daliborka Miletić
Mirjana Bjeloš
Borna Šarić
Damir Bosnar
author_facet Biljana Kuzmanović Elabjer
Mladen Bušić
Daliborka Miletić
Mirjana Bjeloš
Borna Šarić
Damir Bosnar
author_sort Biljana Kuzmanović Elabjer
collection DOAJ
description We would like to present a surgical technique of orbital socket reconstruction using oversized dermis fat graft and 22 mm silicone orbital implant in a single-stage after extended enucleation in two patients with massive local recurrence of anteriorly located choroidal melanoma previously treated with endoresection. Orbital tissues en bloc were removed leaving conjunctival lining only at the fornices. Simultaneously, the 22 mm silicone sphere was implanted deeply into the orbit and covered with the oversized dermis fat graft of 30 mm in height and 35 mm in length with 20 mm of the fat thickness. The graft was sutured to the residual forniceal conjunctiva with interrupted 6/0 absorbable sutures overlapping conjunctiva with the graft edge for 2 mm to facilitate the epithelization. Epithelization was completed in two months, leaving well-formed fornices with good fitting of the prosthesis. The key point of orbital socket reconstruction after extended enucleation is to restore conjunctival lining prior to volume. Thus, whenever facing a massive volume and conjunctival lining loss, simultaneous insertion of the 22 mm silicone sphere deep into the orbit combined with oversized dermis fat graft is, in our opinion, the method of choice. It proved to be safe and effective with favourable long-term results.
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institution Kabale University
issn 2090-6722
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language English
publishDate 2018-01-01
publisher Wiley
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series Case Reports in Ophthalmological Medicine
spelling doaj-art-8a33ea68fdbb4f44b8091a48db91d3e72025-02-03T01:30:51ZengWileyCase Reports in Ophthalmological Medicine2090-67222090-67302018-01-01201810.1155/2018/89541938954193Single-Stage Orbital Socket Reconstruction Using the Oversized Dermis Fat Graft and the 22 mm Silicone Orbital Implant after an Extended EnucleationBiljana Kuzmanović Elabjer0Mladen Bušić1Daliborka Miletić2Mirjana Bjeloš3Borna Šarić4Damir Bosnar5University Eye Clinic, Faculty of Dental Medicine and Health Care Osijek, Faculty of Medicine Osijek, University Josip Juraj Strossmayer in Osijek, University Hospital “Sveti Duh”, Zagreb, CroatiaUniversity Eye Clinic, Faculty of Dental Medicine and Health Care Osijek, Faculty of Medicine Osijek, University Josip Juraj Strossmayer in Osijek, University Hospital “Sveti Duh”, Zagreb, CroatiaUniversity Eye Clinic, Faculty of Dental Medicine and Health Care Osijek, Faculty of Medicine Osijek, University Josip Juraj Strossmayer in Osijek, University Hospital “Sveti Duh”, Zagreb, CroatiaUniversity Eye Clinic, Faculty of Dental Medicine and Health Care Osijek, Faculty of Medicine Osijek, University Josip Juraj Strossmayer in Osijek, University Hospital “Sveti Duh”, Zagreb, CroatiaUniversity Eye Clinic, Faculty of Dental Medicine and Health Care Osijek, Faculty of Medicine Osijek, University Josip Juraj Strossmayer in Osijek, University Hospital “Sveti Duh”, Zagreb, CroatiaUniversity Eye Clinic, Faculty of Dental Medicine and Health Care Osijek, Faculty of Medicine Osijek, University Josip Juraj Strossmayer in Osijek, University Hospital “Sveti Duh”, Zagreb, CroatiaWe would like to present a surgical technique of orbital socket reconstruction using oversized dermis fat graft and 22 mm silicone orbital implant in a single-stage after extended enucleation in two patients with massive local recurrence of anteriorly located choroidal melanoma previously treated with endoresection. Orbital tissues en bloc were removed leaving conjunctival lining only at the fornices. Simultaneously, the 22 mm silicone sphere was implanted deeply into the orbit and covered with the oversized dermis fat graft of 30 mm in height and 35 mm in length with 20 mm of the fat thickness. The graft was sutured to the residual forniceal conjunctiva with interrupted 6/0 absorbable sutures overlapping conjunctiva with the graft edge for 2 mm to facilitate the epithelization. Epithelization was completed in two months, leaving well-formed fornices with good fitting of the prosthesis. The key point of orbital socket reconstruction after extended enucleation is to restore conjunctival lining prior to volume. Thus, whenever facing a massive volume and conjunctival lining loss, simultaneous insertion of the 22 mm silicone sphere deep into the orbit combined with oversized dermis fat graft is, in our opinion, the method of choice. It proved to be safe and effective with favourable long-term results.http://dx.doi.org/10.1155/2018/8954193
spellingShingle Biljana Kuzmanović Elabjer
Mladen Bušić
Daliborka Miletić
Mirjana Bjeloš
Borna Šarić
Damir Bosnar
Single-Stage Orbital Socket Reconstruction Using the Oversized Dermis Fat Graft and the 22 mm Silicone Orbital Implant after an Extended Enucleation
Case Reports in Ophthalmological Medicine
title Single-Stage Orbital Socket Reconstruction Using the Oversized Dermis Fat Graft and the 22 mm Silicone Orbital Implant after an Extended Enucleation
title_full Single-Stage Orbital Socket Reconstruction Using the Oversized Dermis Fat Graft and the 22 mm Silicone Orbital Implant after an Extended Enucleation
title_fullStr Single-Stage Orbital Socket Reconstruction Using the Oversized Dermis Fat Graft and the 22 mm Silicone Orbital Implant after an Extended Enucleation
title_full_unstemmed Single-Stage Orbital Socket Reconstruction Using the Oversized Dermis Fat Graft and the 22 mm Silicone Orbital Implant after an Extended Enucleation
title_short Single-Stage Orbital Socket Reconstruction Using the Oversized Dermis Fat Graft and the 22 mm Silicone Orbital Implant after an Extended Enucleation
title_sort single stage orbital socket reconstruction using the oversized dermis fat graft and the 22 mm silicone orbital implant after an extended enucleation
url http://dx.doi.org/10.1155/2018/8954193
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