Dermal-fat graft for anophthalmic socket in children enucleated for retinoblastoma

Abstract

Retinoblastoma is the most frequent intraocular tumour in childhood. The definitive treatment is enucleation. The management of the anophthalmic socket consists in the use of a plastic implant. The problem is that they are expensive and they usually extrude. The use of dermal-fat grafts minimises the hemi-facial hypoplasia. They usually grow with the face, and help to expand the orbital bones, thus avoiding the psychological and physical consequences.

Objective: To determine if there is hemi-facial hypoplasia, using MRI images after the use of a dermal-fat implant in patients enucleated for RB.

Method: The study included patients enucleated for RB in which a dermal-fat implant was used and MRI images were taken in the period between June 2010 and December 2012. Facial growth and cosmesis was measured.

Results: The study included 12 patients, aged between 6 to 41 months. After 24 months of follow up, none of them developed hemifacial hypoplasia. All had a good cosmesis with the prosthesis. There were no complications after the surgery.

Conclusions: The use of dermal-fat implant is a good option for the anophthalmic socket in patients with RB after enucleation.

Keywords: Anophthalmic socket; Cavidad anoftálmica; Dermal-fat implant; Hemifacial hypoplasia; Hipoplasia hemifacial; Injerto dermograso; Retinoblastoma.