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Year : 2008  |  Volume : 56  |  Issue : 2  |  Page : 147-148

Management of an irradiated anophthalmic socket following dermis-fat graft rejection: A case report

1 Department of Ocularistry, LV Prasad Eye Institute, Hyderabad, India
2 Department of Ophthalmic and Facial Plastic Surgery Orbit and Ocular Oncology, Aditya Jyot Eye Hospital Pvt. Ltd. and Department of Ocular Oncology, Tata Memorial Centre, Mumbai, India
3 Department of Ophthalmic Plastic Surgery Orbit and Ocular Oncology, LV Prasad Eye Institute, Hyderabad, India

Correspondence Address:
Kuldeep Raizada
LV Prasad Eye Institute, LV Prasad Marg, Banjara Hills, Hyderabad - 500 034
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0301-4738.39121

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Dermis-fat graft (DFG) is often the only promising option in cases of severely contracted sockets. However, there is an increased risk of graft failure in irradiated sockets with decreased vascularity. In such difficult cases, repeat DFG implantation also has higher risks of graft failure. We describe an ingenious method of successful management of an irradiated anophthalmic socket following DFG infection and necrosis, with acceptable cosmetic results. At surgery, an orbital impression was taken with ophthalmic grade alginate. Based on this measurement, a custom-made stem pressure socket-expander made up of high density polymethyl methacrylate (PMMA) was fitted, a week post surgery and kept in situ for six weeks. On review, the fornices had considerably deepened. The expander device was removed and the patient was now fitted with a custom-made thicker prosthesis made up of high-density PMMA. The patient has followed up for a year subsequently and the prosthesis has remained stable.

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