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  • Title: Repair of orbital implant exposure using Müller's muscle flap.
    Author: Delmas J, Adenis JP, Robert PY.
    Journal: J Fr Ophtalmol; 2014 Oct; 37(8):618-22. PubMed ID: 25262055.
    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.
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