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The Use of Dermis-Fat Graft to Treat Medpor Exposure and to Augment Orbital Volume in Pediatric Postenucleation Retinoblastoma Patients 1. Min Joung Lee¹ ¹College of medicine, Seoul National University, Seoul, Republic of Korea PURPOSE: To demonstrate the use of the autogenous dermis-fat graft for the treatment of porous polyethylene implant (Medpor®) exposure and volume augmentation in postenucleation retinoblastoma children. METHODS: Twelve children who received a dermis-fat graft at Seoul National University Hospital between July 2005 and January 2010 were included in this study. All patients had undergone unilateral enucleation for retinoblastoma, received a subconjunctival dermis-fat graft to repair implant exposure or enhance the durability of the conjunctival surface and simultaneously correct enophthalmos. The clinical characteristics of the patients, rate of graft survival, and complications were analyzed. The cosmetic outcome was assessed using grading system. RESULTS: All patients had enucleation using Medpor® as a primary orbital implant. Ten patients had definite exposure, and the average time to exposure was 89.1 ± 22.4 months. Two patients who had severe enophthalmos with thin conjunctiva received implantation of a subperiosteal porous polyethylene implant combined with a subconjunctival dermis-fat graft. With a mean follow up 26.8 ± 18.7 months, 11 (91.7 %) of 12 patients showed well-survived graft without re-exposure. One patient who experienced a graft failure managed with implant rotation and scleral graft. Nine patients (75 %) showed significant improvement of enophthalmos. CONCLUSIONS: The autogenous dermis-fat graft is a procedure that can be effectively used to treat Medpor® exposure and simultaneously correct enophthalmos. Use of this procedure can be particularly advantageous for pediatric postenucleation patients. |
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