Orbital Dermis-Fat Graft Transplantation: Results in Primary and Secondary Implantation

Objectives: Autologous dermis fat graft (DFG) is being used in both primary and secondary socket surgeries. In the present study, we aimed to evaluate patients' satisfaction and possible intra- and postoperative complications in patients who had DFG transplantation. Materials and Methods: In this retrospective study, the results of 17 patients who were operated between October 2008 and October 2012 were evaluated. Of these cases, 7 had primary and 10 had secondary DFG. Patient satisfaction was evaluated by asking the patients to fill out a questionnaire graded from 1 (not satisfied) to 4 (very satisfied). Additionally, the incidence of complications and requirement for another operation was noted. Results: The average patient age was 30.5 +/- 17.9 years. Patients with primary grafts were 100% satisfied with the outcome and could wear their prosthesis without any discomfort. In this group, one patient had delay in epithelialisation of the graft and ptosis, which was treated with frontal sling surgery and artificial tears. In patients with secondary grafts, 6 patients (60%) were satisfied with the outcome. Four patients were not satisfied from the result. One had inferior lid laxity; however, after lateral tarsal strip surgery, she could wear her prosthesis. Another patient developed inferior forniceal adhesion. He was treated with mucous membrane grafting and artificial tears and could wear his prosthesis. One patient had infection and contraction of the socket due to inappropriate postoperative medication use. Following repeated DFG transplantation, he was able to wear his prosthesis. Another patient had fat atrophy prior to secondary DFG transplantation and developed atrophy of the graft following surgery. Her family refused additional surgery. This patient could not wear any prosthesis. Conclusion: According to our results, we believe that DFG transplantation is successful in primary implantation. In secondary cases, correct patient selection is important to achieve good outcome