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In this retrospective, observational study authors reviewed 27 eyes of 27 anophthalmic patients with implant exposure who had received a retroauricular myoperiosteal graft. Their main outcome measure was long-term coverage of implant and the secondary outcome was rate of post-surgical complications and management. Implant exposure was defined as a conjunctival defect or progressive conjunctival thinning with imminent exposure. Implant materials were porous polythethylene in 17 patients, hydroxyapatite in three, bioceramics in four and unknown in three. The myoperiosteal graft was harvested from the retroauricular sulcus and applied to the recipient bed with periosteal surface facing outward and then sutured to scleral edges with 6-0 Vicryl. The Tenon’s capsule and conjunctiva were advanced to the margin of the implant and sutured to the periosteal surface with interrupted 6-0 Vicryl sutures, leaving the central area uncovered for a maximum of 12mm. Mean exposure diameter was 5.9 ±3.1mm. Mean follow-up after graft surgery was 37.5 ±39 months. Four patients had further implant reexposure and two of these had re-graft using the same technique. Five patients developed single or multiple conjunctival pyogenic granulomas which were surgically excised.

Retroauricular myoperiosteal auto graft for orbital implant exposure: 11 years of experience.
Medel R, Cicinelli MV, Hurtado JCA, et al.
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Rina Bhatt

Wolverhampton Eye Infirmary, UK.

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