The Resurlts And Postoprative Complications In Contracted Socket Reconstruction Using Auto Dermis-fat Graft-an Retrospective Study

Purpose: To evaluate the results of using autogeneous dermis-fat graft for the treatment of anophthalmic socket and present the postoperactive complications of this procedure.Methods: the 12 patients were inrolled in this retrospective study form2013.11.1to 2018.11.1 in The First Hospital Of Guangxi Medical University.The patients include having undergone primary enucleation or orbital exenteration for malignancies or traumatic diseases,but the porous polyethylene implant was failure to simultaneously correct enophthalmos because of inadequate or repetitive exposure,and patients who suffer from contracted socket attributing to chronic orbital infection or symblepharon insead of enucleation or exenteration.the study enrolled 12 patients(7 male and 5 female),totally 12 cotracted eye sockets.All of them suffered from the socket contraction,and auto dermis-fat graft is transplanted to reconstuct the sockets instead of porous polyethylene implant.We reviewed the medical records of these patients to obtain,record and analysis the following data:demographics,medical history,the cosmetic grades of primary and postoprative sockets,postoprative complicationsin follow-up periods.The cosmetic outcome was assessed to total 4 grades using a grading system.Results: With a mean follow-up of 32.3±17.0 months,9 of 12 patients showed better cosmetic outcomes,with grading above 2 grades(75%).the postoperative cosmetic scores were significantly higher compared to the preoperative’s(P=0.04).The rank sum test showed that the factors,including operation frequency(P=0.05),irradiated sockets(P=0.079),primary exposure(P=0.029),probably related to the postoperative cosmetic grades.In the follow-up periods,a major complication of graft atrophy occurred in 5patients,contributing to primiary enucleation or exenteration,operation frequency(P=0.05),irradiated sockets(P=0.079)and primary exposure(P=0.029),witch change the orbital blood flow,matabolic activities and spatial architecture disturbance.A serious complication of graft necrosis occurred in 1 patient,witch probably conribute to the irridiation of the socket in his youth,leading to the maldevelopment of the socket and the difficulty in graft survival.Conclusions: Auto dermis-fat graft for reconstuction of constracted orbit with orbital soft tissue defect represent a reliable method.the factors including operation frequency,irradiated sockets,primary exposure probably related to the postoperative complications including graft atrophy and necosis,and ultimately influences the cosmetic outcomes.