Fornix Deepening by Using Amniotic Membrane Transplant

Abstract

Objective: To assess the cosmetic outcomes of fornix deepening by using Amniotic membrane transplant in anophthalmic sockets in terms of good retention of ocular prosthesis. Abstract: Methods: This interventional case series was carried out at Khalid eye clinic, Karachi during the period of March 2019 to August 2019. Twenty-five patients belonging to either gender between the ages of 20 to 50 years were included, having anophthalmic sockets with fornix deformities incapable of retaining ocular prosthesis due to variable causes such as cicatrization, symblepharon, cyst, or poor conjunctival suturing technique following evisceration or enucleation. Amniotic membrane was transplanted following the division of bands, excision of cyst and release of adhesions. Pre and post fornix measurements were done and each patient was followed for a duration of six months after the operation to observe the cosmetic appearance and retention of ocular prosthesis. Results: Good cosmetic outcome with retention of ocular prosthesis was achieved in twenty-three (92%) cases, whereas two (8%) cases ended up in failure despite multiple surgeries. The mean pre-operative lower fornix depth was 3.8 ± 1.23 mm, which improved to 8.9 ± 1.10 mm (p- value < 0.001). None of the patients developed any infection or graft rejection. Conclusion: Fornix reconstruction in an anophthalmic socket is a challenging task, but a good cosmetic outcome can be achieved using amniotic membrane transplantation together with good oculoplastic surgical expertise.