Objective
To evaluate the effects of retro-orbital intramuscular cone injection of fat in the treatment of posttraumatic enophthalmos in both patients with intact globes and those patients who have had globes removed.
Design
Case series.
Setting
Private practice involving an otolaryngologist and an ophthalmologist.
Patients
Three groups of patients were treated: group 1 included those patients with an intact globe; group 2, patients with an orbital implant following enucleation; and group 3, patients with no orbital implant following enucleation.
Intervention
Autogenous fat was harvested from the abdomen using a microsuction lipectomy technique. The fat was injected into the intramuscular cone in the retrobulbar or retroimplant space using a 14-gauge needle.
Outcome
Sustained improvement of enophthalmos measured by Hertel's exophthalmometry in those patients with an intact globe. Subjective appearance of prosthesis by physician and patient were used for end points in patients whose globes were removed.
Results
In group 1, all patients were able to maintain a correction to within 1 mm of the normal eye. In groups 2 and 3, all patients had a subjective improvment in appearance, but they had development of enophthalmos if the prosthesis was decreased in size. Seven patients (64%) required multiple injections.
Conclusion
Retro-orbital injection of fat autografts allows correction of persistent posttraumatic enophthalmos.
(Arch Otolaryngol Head Neck Surg. 1994;120:835-839)
