Abstract
Purpose
To report the efficacy of a full-thickness skin graft (FTSG) for the reconstruction of a contracted eye socket.
Design
A retrospective, non-comparative, interventional case series.
Methods
This was a retrospective review of patients with a contracted eye socket who underwent socket reconstruction using a post-auricular FTSG from 2001 to 2011 at the National Taiwan University Hospital. The postoperative results including prosthetic fitting, the cosmetic result, and eyelid function were assessed.
Results
There were 11 male and 15 female patients, with a mean age of 52.3 ± 15.6 years (range 21 to 76). The duration of the socket contracture varied from three months to three years (average 7.4 ± 8.1 months). The severity of the socket contracture ranged from grade 2 to grade 4, based on Tawfik’s classification. The mean follow-up time was 35.7 ± 9.6 months. After socket reconstruction, using a post-auricular FTSG, 96 % of the cases (25 of 26) demonstrated a successful prosthetic fitting and a satisfactory cosmetic outcome. Both good eyelid function and a stable fornix depth were maintained during the follow-up time. One case received a second socket reconstruction three months after the first operation, using a FTSG, because of an inadequate lateral fornix. The final result was satisfactory. There were no serious complications, but a granuloma formed in one case, and there was prolonged discharge in one case.
Conclusions
The reconstruction of a contracted eye socket using a post-auricular FTSG is an effective method with a high success rate, which causes less discomfort to donor sites and results in few complications.
Similar content being viewed by others
References
Tawfik HA, Raslan AO, Talib N (2009) Surgical management of acquired socket contracture. Curr Opin Ophthalmol 20:406–411. doi:10.1097/ICU.0b013e32832ed85b
Klein M, Menneking H, Bier J (2000) Reconstruction of the contracted ocular socket with free full-thickness mucosa graft. Int J Oral Maxillofac Surg 29:96–98
Bowen Jones EJ, Nunes E (2002) The outcome of oral mucosal grafts to the orbit: a three-and-a-half-year study. Br J Plast Surg 55:100–104. doi:10.1054/bjps.2001.3779
Nasser QJ, Gombos DS, Williams MD, Guadagnolo BA, Morrison WH, Garden AS, Beadle BM, Canseco E, Esmaeli B (2012) Management of radiation-induced severe anophthalmic socket contracture in patients with uveal melanoma. Ophthal Plast Reconstr Surg 28:208–212. doi:10.1097/IOP.0b013e31824dd9b8
Holck DE, Foster JA, Dutton JJ, Dillon HD (1999) Hard palate mucosal grafts in the treatment of the contracted socket. Ophthal Plast Reconstr Surg 15:202–209
Lee AC, Fedorovich I, Heinz GW, Kikkawa DO (2002) Socket reconstruction with combined mucous membrane and hard palate mucosal grafts. Ophthalmic Surg Lasers 33:463–468
Yoshimura Y, Nakajima T, Yoneda K (1995) Use of the palatal mucosal graft for reconstruction of the eye socket. J Craniomaxillofac Surg 23:27–30
Abood MH, Weyes MM (2006) Post-traumatic reconstruction of the enucleated contracted eye socket: a comparative study. J Craniofac Surg 17:224–230
Tsur H, Kaplan H, Shafir R, Rosner M, Orenstein A, Rosen N (1991) Repair of the severely contracted socket with meshed skin graft and semi-rigid conformer. Ophthalmic Surg 22:269–273
Poonyathalang A, Preechawat P, Pomsathit J, Mahaisaviriya P (2005) Reconstruction of contracted eye socket with amniotic membrane graft. Ophthal Plast Reconstr Surg 21:359–362
Bajaj MS, Pushker N, Singh KK, Chandra M, Ghose S (2006) Evaluation of amniotic membrane grafting in the reconstruction of contracted socket. Ophthal Plast Reconstr Surg 22:116–120. doi:10.1097/01.iop.0000200887.26015.d4
Levin PS, Dutton JJ (1990) Polytef (polytetrafluoroethylene) alloplastic grafting as a substitute for mucous membrane. Arch Ophthalmol 108:282–285
Demirci H, Elner SG, Elner VM (2010) Rigid nylon foil-anchored polytetrafluoroetyhlene (Gore-Tex) sheet stenting for conjunctival fornix reconstruction. Ophthalmology 117:1736–1742. doi:10.1016/j.ophtha.2010.01.061
Karesh JW, Putterman AM (1988) Reconstruction of the partially contracted ocular socket or fornix. Arch Ophthalmol 106:552–556
Li J, Lin M, Ge S, Fan X (2012) Secondary reconstruction of severe contracted eye socket using modified ocular conformer-drainage tube system. J Craniofac Surg 23:1054–1058. doi:10.1097/SCS.0b013e3182564f31
Putterman AM, Karesh JW (1988) A surgical technique for the successful and stable reconstruction of the totally contracted ocular socket. Ophthalmic Surg 19:193–201
Betharia SM, Patil ND (1988) Dermis fat grafting in contracted socket. Indian J Ophthalmol 36:110–112
Li D, Jie Y, Liu H, Liu J, Zhu Z, Mao C (2008) Reconstruction of anophthalmic orbits and contracted eye sockets with microvascular radial forearm free flaps. Ophthal Plast Reconstr Surg 24:94–97. doi:10.1097/IOP.0b013e318166dad1
Neuhaus RW, Baylis HI, Shorr N (1982) Complications at mucous membrane donor sites. Am J Ophthalmol 93:643–646
Mauriello JA Jr, Wasserman B, Allee S, Robinson L (1992) Molded acrylic mouthguard to control bleeding at the hard palate graft site after eyelid reconstruction. Am J Ophthalmol 113:342–344
Markiewicz MR, DeSantis JL, Margarone JE 3rd, Pogrel MA, Chuang SK (2008) Morbidity associated with oral mucosa harvest for urological reconstruction: an overview. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg 66:739–744. doi:10.1016/j.joms.2007.11.023
Betharia SM, Kanthamani, Prakash H, Kumar S (1990) Skin grafting in severely contracted socket with the use of ‘Compo’. Indian J Ophthalmol 38:88–91
Teller P, White TK (2009) The physiology of wound healing: injury through maturation. Surg Clin N Am 89:599–610. doi:10.1016/j.suc.2009.03.006
Conflict of interest
The authors have declared that no competing interests exist.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Wei, Y.H., Liao, S.L. The reconstruction of a contracted eye socket using a post-auricular full-thickness skin graft. Graefes Arch Clin Exp Ophthalmol 252, 821–827 (2014). https://doi.org/10.1007/s00417-014-2600-z
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-014-2600-z