EYE SOCKET RECONSTRUCTION WITH THE PREFABRICATED TEMPORAL ISLAND FLAP

Insufficiency of tissues and progressive contraction usually restrict the application of prosthetic devices in anophthalmic eye sockets. To achieve a successful reconstruction, the plastic surgeon has to form a socket that has proper dimensions and is completely covered by a well vascularized epithelial surface. Eye socket reconstruction with free skin, mucous membrane, or dermis-fat grafts usually remains unsatisfac tory in severe cases. We have used a prefabricated temporal island fla p to solve this difficult problem since 1983. Tn this method, a full-t hickness skin graft is applied over the temporal fascia to create a pr efabricated island flap based on the superficial temporal vessels. Thi s flap is transposed into the eye socket 3 weeks later. Some modificat ions in flap design have been done to get better fitting of the prosth esis since that time. Thirty-three patients with constricted eye socke ts that could not use prosthetic devices were treated with prefabricat ed temporal island flaps since 1983. The follow-up period was between 1 and 13 years. Eye sockets with adequate size and volume were created in all patients, and the results were successful. This method prevent ed secondary graft shrinkage, and the prefabricated island flaps prese rved their dome shape during the follow-up period. We believe this met hod is a useful one in the treatment of the contracted socket.