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Eye Socket Reconstruction

Eye socket reconstruction involves the surgical reconstruction of a socket that once had an eye but now has undergone either an enucleation or evisceration. Oftentimes after such surgery, the eye socket undergoes changes such as scarring or loss of volume that make the placement of an ocular prosthetic (also termed artificial eye) difficult or uncomfortable. Furthermore, the socket may be very disfiguring. Dr. Zoumalan has extensive experience in reconstructing sockets that have undergone excessive scarring or loss of volume. There are various types of techniques that can be employed in the reconstruction a socket and Dr. Zoumalan needs to examine you carefully to determine the best option.

The techniques that Dr. Zoumalan uses can involve either one or a combination of the below procedures to reconstuct a socket:

1) Dermis-Fat Grafting:

This type of graft is taken from the patient’s abdomen or thigh in a cosmetically acceptable location and allows for an adequate reconstruction of sockets that have loss of volume and also scarring and shortening of their socket tissues.

2) Buccal Mucosal Grafting:

This type of graft is taken from the inside of the patient’s mouth and acts as a suitable tissue to line the outside surface of the eye socket. It is an adequate reconstruction for those sockets that may only have shortening of their eye tissues but already have good volume.

3) Alloderm Grafting or Amniotic Membrane Grafting:

These are alternative types of grafts that act as substitute to a buccal mucosal graft. The advantage to these grafts are that they are not harvested from the patient’s own body and do not require the patient to undergo a second surgical site to remove tissue.

4) Secondary placement of an orbital implant:

Often the implant that is already placed in the eye socket needs to be removed either due to an infected eye socket and implant, extrusion of the implant, or inadequate volume of the eye socket (enophthalmos). As a result, the implant needs to be removed and Dr. Zoumalan may go ahead and place another implant at the same time if possible. If the eye socket is infected, the implant will be removed and the eye socket will be left to heal. Another surgery to place a secondary implant will be planned at a later date in those particular cases.

5) Eyelid reconstruction (either upper or lower eyelid or both):

Eye sockets may also undergo eyelid abnormalities such as ptosis, lid contour deformities, and lower lid malpositions (such as ectropions and entropions). These can also be addressed at the same time as an eye socket surgery or a later date.

6) Intraorbital injection of synthetic fillers or fat grafting:

In selected cases, Dr. Zoumalan may offer intraorbital filler injections in cases of enophthalmos in eye sockets.

Common Question and Answers
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    Preoperative Diagnosis: Leftsunken eye appearance (enophthalmos).

    Procedure performed: Repair of enophthalmos using socket reconstruction and volume augmentation through Medpor alloplastic implants.

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    Preoperative Diagnosis: Leftsunken eye appearance (enophthalmos).

    Procedure performed: Repair of enophthalmos using socket reconstruction and volume augmentation through Medpor alloplastic implants.