Surgical repair of orbital fat prolapse by conjunctival fixation to the sclera

Natsuko Nakamura,1 Kunihiko Akiyama,1,2 Chika Shigeyasu,1,3 Masakazu Yamada1,31Division for Vision Research, National Institute of Sensory Organs, National Tokyo Medical Center, Tokyo, 2Department of Ophthalmology, National Tokyo Medical Center, Tokyo, 3Department of Ophthalmology, Kyorin University School of Medicine, Mitaka, JapanPurpose: The aim of the study described here was to report the outcomes of surgery for orbital fat prolapse by conjunctival fixation to the sclera.Patients and methods: Twenty-three consecutive eyes of 19 patients with orbital fat prolapse were retrospectively reviewed. All cases were treated with the same simple procedure without resection through conjunctival incision: fixation of conjunctiva to the sclera with interrupted sutures of 10-0 nylon in two rows located approximately 12–14 mm posterior to the limbus. These sutures formed an embankment to keep the prolapsed fat posteriorly. Postoperative results were determined by slit-lamp examination and recurrence of prolapse was defined as the presence of orbital fat anterior to the embankment.Results: During the mean follow-up period of 19 months (range: 1-59 months), one case experienced recurrence which required further surgery. None of the other cases experienced recurrence, and there were no intraoperative or postoperative complications.Conclusion: Conjunctival fixation to the sclera was a simple and effective surgical technique for orbital fat prolapse, with less invasion compared to the conventional method that requires conjunctival incision.Keywords: surgical technique, herniation, orbital fat, conjunctiva, suture, 10-0 nylon