Surgical treatment of an exposed orbital implant with vascularized superficial temporal fascia flap.

Orbital implants are often used for the correction of volume deficit after enucleation or evisceration. An orbital implant enhances aesthetics and improves mobility of the subsequent prosthetic eye. With advancements in technology and techniques, implant-related complication rates have been decreased. However, implant exposition as one of the most common complications of socket surgery is still a problem for the oculoplastic surgeon. Many factors are thought to cause orbital implant exposure: Large implants, tension on the wound, and textured surface of the implant may cause a breakdown of the covering layers over the implant. Inadequate fibrovascular ingrowth into the porous implant is the most important factor. Various surgical methods have been described to cover the defect, most offering the use of various tissues as a graft, which are not always satisfactory. We describe a case with silicone implant exposition that was managed with a vascularized superficial temporal fascia flap. According to our knowledge, this is the first article reporting the usage of a vascular tissue in the management of an orbital implant exposure.