Rigid nylon foil-anchored polytetrafluoroetyhlene (Gore-Tex) sheet stenting for conjunctival fornix reconstruction.

PURPOSE: To describe an operative technique that deepens foreshortened conjunctival fornices by providing a scaffold for epithelialization that opposes contractile forces during wound healing.

DESIGN

Retrospective interventional case series.

PARTICIPANTS

Seventeen patients with anophthalmic sockets containing foreshortened conjunctival fornices.

METHODS

Conjunctival fornices was reconstructed with stents of expanded polytetrafluoroethylene (e-PTFE) sheet draped over rigid, 0.8-mm thick-nylon strips that were anchored to the orbital rim. Preoperative and postoperative symptoms, prosthesis retention, fornix depth, and lagophthalmos were assessed.

MAIN OUTCOME MEASURES: Prosthesis retention, fornix depth, and lagophthalmos.

RESULTS

All 17 patients had preoperative inability to retain their prosthesis. After postoperative follow-up of 47+/-43 months, retention was improved in all patients and was entirely satisfactory in 15 (88%) patients. After reconstruction, the repaired fornix was deep in 7 (41%) patients, adequate to retain a prosthesis in 9 (53%), and shallow in 1 (6%). Lagophthalmos improved in 15 (88%) patients and remained unchanged in 2 (12%). The superior fornix was reconstructed concurrently with the inferior fornix in 6 patients. In these patients, the superior fornix improved to deep (3 patients; 50%) or adequate (2; 33%). In 1 (17%) patient, it remained shallow.

CONCLUSIONS

Rigid, nylon foil-anchored e-PTFE stenting opposes postoperative contracture, improving prosthesis retention, and lagophthalmos. It does not require an additional surgical site for graft harvesting.