Postoperative Outcomes of Anophthalmic Socket Reconstruction Using an Autologous Buccal Mucosa Graft

Abstract

Socket contracture is one of the most common and difficult problems in anophthalmic patients. This study intended to evaluate postoperative outcomes of anophthalmic socket reconstruction using an autologous buccal mucosa graft in patients with socket contracture. Medical records and photographs of 44 anophthalmic patients who underwent socket reconstruction surgery using an autologous buccal mucosa graft were reviewed retrospectively. The time necessary for the graft surface to be completely vascularized was assessed, and fornix depth was measured before and 6 months after surgery. Postoperative cosmetic and functional outcomes were evaluated, and the factors that influence postoperative outcomes were investigated. The surgery was performed without any significant complications, and the patients only complained of oral discomfort within 1 week. The graft surface was fully vascularized about 1.1 months after surgery. Mean fornix depth after surgery was significantly deeper than that before surgery (9.1 mm, about 68.2% of the vertical size of the implanted graft). Preoperatively, 50.0% of the patient had cosmetic grades 1 and 2; however, 63.6% of the patients achieved grade 4, and 93.2% had higher than grade 3 after surgery. In functional outcomes, 86.4% of the patients presented functional success. Graft recontracture occurred in only 2 patients. Preoperative severe socket contracture was a factor associated with worse cosmetic outcome (P = 0.001). An autologous buccal mucosa can be a safe and effective graft material for the reconstruction of a contracted socket.

Assessing full thickness oral mucosal grafting: complications and postoperative outcomes in a broad collective of patients

“…Insufficient conjunctival fornix depth and postenucleation socket syndrome are common in anophthalmic patients, impairing the adequate position of prosthesis 31. Increasing the depth of the inferior fornix, thereby augmenting the conjunctival surface area can be achieved with OMG31 and this can improve the fit of the prosthesis 5. We used this procedure successfully in patients with inadequate fornix depth, who presented themselves because of an ill-fitting prosthesis.…”

“…31 Increasing the depth of the inferior fornix, thereby augmenting the conjunctival surface area can be achieved with OMG 31 and this can improve the fit of the prosthesis. 5 We used this procedure successfully in patients with inadequate fornix depth, who presented themselves because of an ill-fitting prosthesis. Revisions due to inadequate fornix depth were only required in two cases.…”

“…Oral mucosal grafts have not only been used in the treatment of contracted sockets in anophthalmic patients3–7 and in ocular surface and fornix reconstruction in patients after tumour resection,8 9 but also in therapy refractive pterygia10 11 and in patients with ocular pemphigoid12 13 or symblephara 14 15. It is also the tissue that is most commonly used in the treatment of postsurgical complications, including conjunctival insufficiencies after glaucoma,16 17 retinal surgery,18 keratoprothesis-related corneal melts19 20 and in lining the dacryocystorhinostomy tract 21.…”

Shallow Inferior Conjunctival Fornix in Contracted Socket and Anophthalmic Socket Syndrome: A Novel Technique to Deepen the Fornix Using Fascia Lata Strips

“…Mucous membrane [ 2 , 9 ] and amniotic membrane [ 10 , 11 ] grafts are the most common tissue used in the reconstruction of the significantly contracted eye socket.…”

“…Contracted socket is a condition characterized by fibrosis of the anophthalmic socket where shallow or obliterated fornix is a key finding in different stages of the disease and it occurs secondary to conjunctival shrinkage [ 2 ].…”