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Abstract
The management of eye removal was a challenge for the ophthalmologist and still. Many materials and designs were used, but none of them had stood against the time factors. The most recent advancement is the development of integrated implants, namely the porous implants and the autogenous dermis fat graft.
The aim of this study was to evaluate the dermis fat as an orbital implant and to compare the results with the currently used implants namely the porous types.
The patients in our study were classified into four groups according to the state of the socket; group one included 22 cases 12 of them were implanted with demis fat autograft after enucleation and 10 of them were implanted with porous implant after enucleation, in group two we had 28 case 11 of them were implanted with dermis fat implant after evisceration and 17 of them were implanted with porous implant after evisceration, both groups one and two comprises the primary group.
The secondary group included two groups; group three included 17 patient 10 of them were implanted with dermis fat autograft after previous enucleation and 7 cases were implanted with porous implant after previous enucleation too, and group four that included 20 cases 11 cases were implanted with dermis fat after previous evisceration and 9 cases were implanted with porous implant after previous evisceration too.
The results in both primary and secondary cases were recorded and compared regarding their cosmetic and functional parameters. In general we had no statistically significant difference between dermis fat autograft and porous implants in primary group or in the secondary group. In the first group the cosmetic results were accepted in 83.14% while the functional results were good in the same cases that were implanted with dermis graft, while in cases that were implanted with porous implants the cosmetic and the functional results were good in 100% of the cases. In the second group that were implanted after evisceration the cosmetic and the functional results were 72% with dermis fat graft and 94% with porous implants. In the third group that were implanted after previous enucleation the cosmetic results were 20% good and 40% accepted with dermis fat graft while in the porous implant the cosmetic results were accepted in 28% with no cases showing good cosmetic results, considering the functional results in this group it was 20% good and 30% accepted with dermis fat, while with porous implants it was 57% accepted without good cases. In the last group, cases that were implanted after previous evisceration, the results were good in 81% in the cosmetic aspect and good in 45% in the functional aspects when using dermis fat and when using the porous implants the results were good in 77.78% in the cosmetic aspects 55.56% good in the functional aspect.