THE TREATMENT OF ENOPHTHALMOS BY ORBITAL INJECTION OF FAT AUTOGRAFT

Objective: To evaluate the effects of retro-orbital intramuscular cone injection of fat in the treatment of posttraumatic enophthalmos in bo th patients with intact globes and those patients who have had globes removed. Design: Case series. Setting: Private practice involving an o tolaryngologist and an ophthalmologist. Patients: Three groups of pati ents were treated: group 1 included those patients with an intact glob e; group 2, patients with an orbital implant following enucleation; an d group 3, patients with no orbital implant following enucleation. Int ervention: Autogenous fat was harvested from the abdomen using a micro suction lipectomy technique. The fat was injected into the intramuscul ar cone in the retrobulbar or retroimplant space using a 14-gauge need le. 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 po ints in patients whose globes were removed. Results: In group 1, all p atients were able to maintain a correction to within 1 mm of the norma l 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 injecti ons. Conclusion: Retro-orbital injection of fat autografts allows corr ection of persistent posttraumatic enophthalmos.