Abstract
Ocular surface reconstruction presents a complex challenge that often requires multiple stages for successful rehabilitation. This chapter explores the crucial role of mucous membrane grafting in the backbone of reconstruction, alongside the prudent utilization of vascular flaps in severe or ischemic cases. Additionally, it highlights the necessity of eyelid-globe reflection for preserving movement, protecting the ocular surface, and facilitating prosthesis placement in anophthalmic cases.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Solomon A, Espana EM, Tseng SC. Amniotic membrane transplantation for reconstruction of the conjunctival fornices. Ophthalmology. 2003;110(1):93–100.
Ding J, et al. Eyelid and fornix reconstruction in abortive cryptophthalmos: a single-center experience over 12 years. Eye (Lond). 2017;31(11):1576–81.
Tseng SC, Prabhasawat P, Lee SH. Amniotic membrane transplantation for conjunctival surface reconstruction. Am J Ophthalmol. 1997;124(6):765–74.
Ucar F, et al. Facilitated tenon-free conjunctival autograft preparation and limited tenon removal technique in pterygium surgery. Klin Monatsbl Augenheilkd. 2021;
Lee JS, et al. Efficacy and safety of a large conjunctival autograft for recurrent pterygium. Korean J Ophthalmol. 2017;31(6):469–78.
Shimazaki J, Shinozaki N, Tsubota K. Transplantation of amniotic membrane and limbal autograft for patients with recurrent pterygium associated with symblepharon. Br J Ophthalmol. 1998;82(3):235–40.
Marticorena J, et al. Pterygium surgery: conjunctival autograft using a fibrin adhesive. Cornea. 2006;25(1):34–6.
Singh PK, et al. Conjunctival autografting without fibrin glue or sutures for pterygium surgery. Cornea. 2013;32(1):104–7.
Shapiro MS, Friend J, Thoft RA. Corneal re-epithelialization from the conjunctiva. Invest Ophthalmol Vis Sci. 1981;21(1 Pt 1):135–42.
Kenyon KR, Tseng SC. Limbal autograft transplantation for ocular surface disorders. Ophthalmology. 1989;96(5):709–22; discussion 722–3.
Henderson HWA, Collin JRO. Mucous membrane grafting. Dev Ophthalmol. 2008;41:230–42.
Osaki TH, et al. Management of severe cicatricial entropion with labial mucous membrane graft in cicatricial ocular surface disorders. J Craniofac Surg. 2018;29(6):1531–4.
Singh S, Narang P, Mittal V. Labial mucosa grafting for lid margin, anterior lamellar, and posterior lamellar correction in recurrent cicatricial entropion. Orbit. 2021;40(4):301–5.
Koreen IV, Taich A, Elner VM. Anterior lamellar recession with buccal mucous membrane grafting for cicatricial entropion. Ophthalmic Plast Reconstr Surg. 2009;25(3):180–4.
BhalaguruIyyan A, et al. Evaluation of the extent of primary buccal mucosal graft contracture in augmentation Urethroplasty for stricture urethra: a prospective observational study at a tertiary healthcare Centre. Adv Urol. 2021;2021:9913452.
Lauer G, Schimming R, Frankenschmidt A. Intraoral wound closure with tissue-engineered mucosa: new perspectives for urethra reconstruction with buccal mucosa grafts. Plast Reconstr Surg. 2001;107(1):25–33.
Muruganandam K, et al. Closure versus nonclosure of buccal mucosal graft harvest site: a prospective randomized study on post operative morbidity. Indian J Urol. 2009;25(1):72–5.
Wood DN, et al. The morbidity of buccal mucosal graft harvest for urethroplasty and the effect of nonclosure of the graft harvest site on postoperative pain. J Urol. 2004;172(2):580–3.
Geerling G, Raus P, Murube J. Minor salivary gland transplantation. Dev Ophthalmol. 2008;41:243–54.
Sant’ Anna AE, et al. Minor salivary glands and labial mucous membrane graft in the treatment of severe symblepharon and dry eye in patients with Stevens-Johnson syndrome. Br J Ophthalmol. 2012;96(2):234–9.
Saluja G, Patel BC, Gupta P. Mucous Membrane Graft. In: StatPearls, Treasure Island (FL); 2022.
Grixti A, Malhotra R. Oral mucosa grafting in periorbital reconstruction. Orbit. 2018;37(6):411–28.
Neuhaus RW, Baylis HI, Shorr N. Complications at mucous membrane donor sites. Am J Ophthalmol. 1982;93(5):643–6.
Kuckelkorn R, et al. Autologous transplantation of nasal mucosa after severe chemical and thermal eye burns. Acta Ophthalmol Scand. 1996;74(5):442–8.
Halama AR, et al. Density of epithelial cells in the normal human nose and the paranasal sinus mucosa. A scanning electron microscopic study. Rhinology. 1990;28(1):25–32.
Wenkel H, Rummelt V, Naumann GO. Long term results after autologous nasal mucosal transplantation in severe mucus deficiency syndromes. Br J Ophthalmol. 2000;84(3):279–84.
Ross GS, Bell J. Myocardial infarction associated with inappropriate use of topical cocaine as treatment for epistaxis. Am J Emerg Med. 1992;10(3):219–22.
Naumann GO, et al. Autologous nasal mucosa transplantation in severe bilateral conjunctival mucus deficiency syndrome. Ophthalmology. 1990;97(8):1011–7.
Suh JD, Ramakrishnan VR, DeConde AS. Nasal floor free mucosal graft for skull base reconstruction and cerebrospinal fluid leak repair. Ann Otol Rhinol Laryngol. 2012;121(2):91–5.
Weinberg DA, et al. Eyelid mucous membrane grafts: a histologic study of hard palate, nasal turbinate, and buccal mucosal grafts. Ophthalmic Plast Reconstr Surg. 2007;23(3):211–6.
Lee AC, et al. Socket reconstruction with combined mucous membrane and hard palate mucosal grafts. Ophthalmic Surg Lasers. 2002;33(6):463–8.
Beatty RL, et al. Intraoral palatal mucosal graft harvest. Ophthalmic Plast Reconstr Surg. 1993;9(2):120–4.
Goldberg RA, et al. Management of severe cicatricial entropion using shared mucosal grafts. Arch Ophthalmol. 1999;117(9):1255–9.
Cohen MS, Shorr N. Eyelid reconstruction with hard palate mucosa grafts. Ophthalmic Plast Reconstr Surg. 1992;8(3):183–95.
Kim JW, Kikkawa DO, Lemke BN. Donor site complications of hard palate mucosal grafting. Ophthalmic Plast Reconstr Surg. 1997;13(1):36–9.
Schmitzer S, et al. The Anophthalmic socket—reconstruction options. J Med Life. 2014;7 Spec No. 4:23–9.
Korn BS, et al. Treatment of lower eyelid malposition with dermis fat grafting. Ophthalmology. 2008;115(4):744–751 e2.
Bhattacharjee K, et al. Comparative analysis of use of porous orbital implant with mucus membrane graft and dermis fat graft as a primary procedure in reconstruction of severely contracted socket. Indian J Ophthalmol. 2014;62(2):145–53.
Inchingolo F, et al. Use of dermal-fat grafts in the post-oncological reconstructive surgery of atrophies in the zygomatic region: clinical evaluations in the patients undergone to previous radiation therapy. Head Face Med. 2012;8:33.
Gupta H, et al. Dermis fat graft for pediatric exenteration-challenging but rewarding. Saudi J Ophthalmol. 2017;31(3):169–72.
Jovanovic N, et al. Reconstruction of the orbit and Anophthalmic socket using the dermis fat graft: a major review. Ophthalmic Plast Reconstr Surg. 2020;36(6):529–39.
Leaf N, Zarem HA. Correction of contour defects of the face with dermal and dermal-fat grafts. Arch Surg. 1972;105(5):715–9.
Davis RE, Guida RA, Cook TA. Autologous free dermal fat graft. Reconstruction of facial contour defects. Arch Otolaryngol Head Neck Surg. 1995;121(1):95–100.
Bonavolonta G, et al. Orbital dermis-fat graft using periumbilical tissue. Plast Reconstr Surg. 2000;105(1):23–6.
Shore JW, et al. Management of complications following dermis-fat grafting for anophthalmic socket reconstruction. Ophthalmology. 1985;92(10):1342–50.
Quaranta-Leoni FM, et al. Dermis-fat graft in children as primary and secondary orbital implant. Ophthalmic Plast Reconstr Surg. 2016;32(3):214–9.
Collar RM, et al. The versatility of the temporoparietal fascia flap in head and neck reconstruction. J Plast Reconstr Aesthet Surg. 2012;65(2):141–8.
Wormald PJ, Alun-Jones T. Anatomy of the temporalis fascia. J Laryngol Otol. 1991;105(7):522–4.
Hashmi A, et al. Safe zone for dissection in frontotemporal region to avoid injury to the temporal branch of facial nerve. J Craniofac Surg. 2021;32(7):2322–5.
Ellis DS, Toth BA, Stewart WB. Temporoparietal fascial flap for orbital and eyelid reconstruction. Plast Reconstr Surg. 1992;89(4):606–12.
Sahin I, et al. Total lower eyelid reconstruction with superficial temporal fascia flap and porous polyethylene implant: a case report. J Plast Reconstr Aesthet Surg. 2012;65(1):110–3.
Rootman DB, et al. Ocular surface, fornix, and eyelid rehabilitation in Boston type I keratoprosthesis patients with mucous membrane disease. Ophthalmic Plast Reconstr Surg. 2015;31(1):43–9.
Koizumi N, et al. Comparison of intact and denuded amniotic membrane as a substrate for cell-suspension culture of human limbal epithelial cells. Graefes Arch Clin Exp Ophthalmol. 2007;245(1):123–34.
Fernandes M, et al. Amniotic membrane transplantation for ocular surface reconstruction. Cornea. 2005;24(6):643–53.
Lee HS, Kim JC. Effect of amniotic fluid in corneal sensitivity and nerve regeneration after excimer laser ablation. Cornea. 1996;15(5):517–24.
Bajaj MS, et al. Evaluation of amniotic membrane grafting in the reconstruction of contracted socket. Ophthalmic Plast Reconstr Surg. 2006;22(2):116–20.
Dua HS, Maharajan VS, Hopkinson A. Controversies and limitations of amniotic membrane in ophthalmic surgery. In: Reinhard T, Larkin DFP, editors. Cornea and external eye disease. Berlin, Heidelberg: Springer Berlin Heidelberg; 2006. p. 21–33.
Hao Y, et al. Identification of antiangiogenic and antiinflammatory proteins in human amniotic membrane. Cornea. 2000;19(3):348–52.
Shanbhag SS, Chodosh J, Saeed HN. Sutureless amniotic membrane transplantation with cyanoacrylate glue for acute Stevens-Johnson syndrome/toxic epidermal necrolysis. Ocul Surf. 2019;17(3):560–4.
Neuhaus RW, Hawes MJ. Inadequate inferior cul-de-sac in the anophthalmic socket. Ophthalmology. 1992;99(1):153–7.
Demirci H, Elner SG, Elner VM. Rigid nylon foil-anchored polytetrafluoroethylene (Gore-Tex) sheet stenting for conjunctival fornix reconstruction. Ophthalmology. 2010;117(9):1736–42.
Putterman AM, Scott R. Deep ocular socket reconstruction. Arch Ophthalmol. 1977;95(7):1221–8.
Lama PJ, Fechtner RD. Antifibrotics and wound healing in glaucoma surgery. Surv Ophthalmol. 2003;48(3):314–46.
Khaw PT, et al. Five-minute treatments with fluorouracil, floxuridine, and mitomycin have long-term effects on human Tenon's capsule fibroblasts. Arch Ophthalmol. 1992;110(8):1150–4.
Priel A, et al. Use of antimetabolites in the reconstruction of severe anophthalmic socket contraction. Ophthalmic Plast Reconstr Surg. 2012;28(6):409–12.
Tawfik HA, et al. Revisiting the role of the myofibroblast in socket surgery: an Immunohistochemical study. Ophthalmic Plast Reconstr Surg. 2016;32(4):292–5.
Kamal S, et al. Serial sub-conjunctival 5-fluorouracil for early recurrent anophthalmic contracted socket. Graefes Arch Clin Exp Ophthalmol. 2013;251(12):2797–802.
Mattout HK, Fouda SM, Al-Nashar HY. Evaluation of topical mitomycin-C eye drops after reconstructive surgery for anophthalmic contracted socket. Clin Ophthalmol. 2021;15:4621–7.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Singh, P., Rootman, D.B. (2023). Fornix Reconstruction. In: Tsui, E., Fung, S.S.M., Singh, R.B. (eds) Current Advances in Ocular Surgery. Current Practices in Ophthalmology. Springer, Singapore. https://doi.org/10.1007/978-981-99-1661-0_2
Download citation
DOI: https://doi.org/10.1007/978-981-99-1661-0_2
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-99-1660-3
Online ISBN: 978-981-99-1661-0
eBook Packages: MedicineMedicine (R0)