Retroauricular myoperiosteal autograft for orbital implant exposure: 11 years of experience

ABSTRACT

Purpose

To describe our experience with retroauricular myoperiosteal autograft for surgical coverage of exposed orbital implants.

Methods

This was a single-center, retrospective, observational cohort study, in which demographic and clinical data were compiled by reviewing the clinical records of anophthalmic patients with implant exposure treated with an autogenous retroauricular myoperiosteal graft at the Instituto de Microcirugía Ocular (IMO, Barcelona, Spain) over the period January 2007 to December 2017. Main outcome was the long-term coverage of implant after retroauricular myoperiosteal autograft; secondary outcome was the rate of post-surgical complications and management.

Results

Over the 11-year period, 27 eyes of 27 patients with implant exposure received a retroauricular myoperiosteal autograft. Mean participant age was 47.3 ± 17.9 years (range 9–78, median 45). Primary surgery was enucleation in 8 eyes (29.6%) and evisceration in 19 (70.4%). Implant materials were porous polyethylene in 17 (63%), hydroxyapatite in 3 (11.1%), and bioceramics in 4 (14.8%). In the remaining three patients (11.1%), the implant material and size were unknown. Implant exposure was diagnosed after a mean of 98 ± 111.7 months. Mean exposure diameter was 5.9 ± 3.1 mm. Mean follow-up duration after graft surgery was 37.5 ± 39 months. In four patients (14.8%), implant re-exposure was recorded and in two of these patients a re-graft using the same technique was performed. In the last follow-up session, all patients showed good implant coverage.

Conclusions

Myoperiosteal graft could be a valid option for the long-term management of implant exposure irrespective of primary surgery, exposed area, and implant material.

KEYWORDS:

• Anophthalmic socket
• implant exposure
• myoperiosteal graft

Contributorship statement

All the authors contributed to the conception or design of the work, the acquisition, analysis and interpretation of data, drafting the work, revising it critically for important intellectual content and gave final approval of the version to be published.

Data deposition

The data that support the findings of this study are available from the corresponding author, [MVC], upon reasonable request.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.