Reconstruction of Contracted Anophthalmic Socket with Acellular Dermal Allograft

PURPOSE: To study the use of acellular dermal allografts for the reconstruction of contracted anophthalmic sockets. METHODS: A retrospective analysis was performed on 12 patients with contracted sockets who underwent reconstructive surgery using acellular dermal allografts from 2002 to 2006. RESULTS: The mean age of the patients was 44.4 years. The mean duration of conjunctival sac contracture after removal of the eyeball was 21.4 years. In 4 patients, acellular dermal allografts were used as spacer grafts to elevate the eyelids, and in 8 patients the allografts were used as a conjunctival grafting material. All patients were able to wear ocular prostheses comfortably 2.2 months after surgery with acceptable cosmesis. There were no serious complications, such as infections or graft rejections during follow-up period. CONCLUSIONS: When used as conjunctival grafting materials and tarsal substitutes to elevate patients' eyelids, acellular dermal allografts gave cosmetically and functionally acceptable results in the surgical rehabilitation of contracted sockets.

Wrapping of Porous Orbital Implant Using Acellular Dermal Allograft

PURPOSE: To investigate the results when using the acellular dermal allograft (SureDerm(R), Hans Biomed Co., Korea) as a new wrapping material for porous orbital implants. METHODS: The charts of 11 patients who underwent either primary or secondary insertion of Medpor(R) orbital implants after enucleation or a new insertion after removal of previous orbital implants were reviewed. Medpor(R) orbital implants either 18 or 20 mm were wrapped with SureDerm(R) in 4x4 cm sections that were 1-mm-thick. Four rectus muscles were fixed to the SureDerm(R) wrapped implant, and a conjunctival suture was made with 6-0 Vicryl. All patients had follow-up periods longer than 10 months and were evaluated to determine the success of wrapping and to identify any complications. RESULTS: The average age of the patients was 48.3 years. The patients wore artificial eyes for 9 weeks after the operation, and the follow-up periods were 22.4 months on average. There was no case of implant or SureDerm(R) exposure, inflammation, and other significant complications except in one case that required fornix reconstruction to allow the subject to wear an artificial eye. CONCLUSIONS: Acellular dermal allograft appears to be a good substitute material if preserved sclera is not available when inserting orbital implants with wrapping.

Treatment of Exposed Hydroxyapatite Orbital Implant Using Acellular Dermal Allograft

PURPOSE: To investigate the results of acellular dermal allograft (SureDerm(R), Hans Biomed Co., Korea) as a new covering material in the exposure of hydroxyapatite orbital implant. METHODS: SureDerm graft was performed in 5 patients with exposed hydroxyapatite orbital implant. Under local anesthesia, the anterior surface of the exposed implant was trimmed and the designed SureDerm was sutured at the margin of the sclera with 6-0 Vicryl. Finally, conjunctival suture was done. The patients were followed up regularly until postoperative 10 months. RESULTS: The average diameter of exposed implant was 9.6 X 9.0 mm. The grafted SureDerm had survived in all patients at postoperative 10 months and exposure of implant was treated successfully in all cases. CONCLUSIONS: We consider that acellular dermal allograft will be a good replacing material when preserved sclera is not available. It also features the advantage of avoiding the intricate harvesting procedure and the scarring of the donor site in dermo-fat graft.