Treatment of Recalcitrant Orbital Implant Exposure using Upper Tarsoconjunctival Flap

ABSTRACT

PURPOSE: This study is to report a case of recalcitrant exposure of Medpor(R) orbital implant which required the use of an upper eyelid tarsoconjunctival flap. METHOD: A six year-old female patient presented with re-exposure of Medpor(R) orbital implant after 2 previous dermis grafts had failed. The downgrown conjunctival epithelial tissues were cryocoagulated. A fornix-based tarsoconjunctival flap was fashioned from the upper lid, inverted and placed over the sclera-covered exposed implant. After placement of a conformer, tarsorrhapy was done. The flap was divided with release of tarsorrhapy as a second stage procedure 4 weeks after the primary surgery. RESULT: The previously exposed implant remained covered and no other complication was observed during a one-year follow-up period. CONCLUSION: Upper tarsoconjunctival flap may be an excellent surgical method in treatment of recurrent exposure of orbital implants refractory to conventional therapies.