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Fat Grafting For Augmentation of Intra-Orbital Volume

Matt Brown, Michelle Lee, Sima Molavi, Samantha Zwiebel, Paul Adenuga, Davood Varghai and Bahman Guyuron
University Hospitals Case Medical Center
2013-02-28

Presenter: Matthew Brown

Affidavit:
The work contained represents the majority of the work of the presenting resident.

Director Name: Hooman Soltanian

Author Category: Resident Plastic Surgery

Introduction: Surgical correction of enophthalmos can be difficult. This is commonly seen in patients with previous facial trauma who lack complete bony reduction or have residual enophthalmos secondary to atrophy of the orbital tissues and periocular fat. Currently methods to adjust the orbital volume require osteotomies or more invasive approaches. Fat grafting may provide a simple and less invasive way to augment orbital volume and correct enophthalmos.

Methods: 10 white New-Zealand rabbits had adipose tissue harvested from the groin. This fat was diced and placed in 1cc syringes. 1cc of fat was injected posterior to axis of the globe along the infraorbital rim. This process was repeated injecting .5cc was along the supraorbital processes. Rabbits underwent CT scans on POD#1 and POD# 70. CT scans were evaluated for change in globe position measuring along the axis from the surface of the cornea to the sphenoid bone adjacent to the optic canal.

Results: Right globe position showed a mean increase in eye proptosis of 3.4mm on POD#1 and .9 mm on POD#70 in comparison to the left globe position. The mean changes in eye position was found to be statistically significant with a P value less than .0001. No significant change was noted in the left globe position of the uninjected left orbit from POD#1 to POD#70.

Conclusions:
Retro-ocular fat injection can augment orbital volume. These modalities may provide a new technique for correction of enophthalmos.

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