Repair of orbital implant exposure using Müller's muscle flap

J Fr Ophtalmol. 2014 Oct;37(8):618-22. doi: 10.1016/j.jfo.2014.04.006. Epub 2014 Sep 26.

Abstract

Introduction: The purpose of this study is to analyse the 2-stage Müller's muscle flap technique for the treatment of orbital implant exposure and its results.

Materials and methods: This retrospective study reviewed all patients undergoing surgery using this technique in our university hospital over a 14-year period (1999-2012) in terms of success (no re-exposure of the implant) or failure.

Results: Nineteen patients were managed using this 2-stage procedure. Orbital implant exposure occurred 94.4 months (2-240) after implantation. The success rate was 68.4% (13/19) and failure rate 31.6% (6/19). Risk factors for exposure were enucleation for melanoma followed by radiation therapy, acrylic implant, and early exposure probably due to excessive suture tension.

Discussion: Implant exposure is the most common complication after evisceration, enucleation or socket surgery. Several techniques to repair exposures have been described. Two-stage Müller's muscle flap is an interesting option, especially for patients presenting defects larger than 4mm(2) and without previous radiation therapy treatment.

Conclusion: The two-stage Müller's muscle flap procedure allows for an autologous vascularized pedicle flap from the ipsilateral upper eyelid. It is a reliable technique with a success rate of 68% in our study.

Keywords: Bille; Cavité; Exposition; Exposure; Flap; Implant; Lambeau; Muscle de Müller; Müller's muscle; Socket.

Publication types

  • Evaluation Study

MeSH terms

  • Adipose Tissue / transplantation
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Blepharoplasty / methods*
  • Child
  • Eye Enucleation
  • Eye Evisceration
  • Eye Neoplasms / surgery
  • Female
  • Humans
  • Male
  • Melanoma / surgery
  • Middle Aged
  • Orbital Implants* / adverse effects
  • Retinoblastoma / surgery
  • Retrospective Studies
  • Risk Factors
  • Surgical Flaps*
  • Suture Techniques / adverse effects
  • Treatment Outcome
  • Wound Healing
  • Young Adult