Repair of orbital implant exposure using Müller's muscle flap

Summary Introduction The purpose of this study is to analyse the 2-stage Muller's muscle flap technique for the treatment of orbital implant exposure and its results. Materials and methods This retrospective study reviewed all patients undergoing surgery using this technique in our university hospital over a 14-year period (1999–2012) in terms of success (no re-exposure of the implant) or failure. Results Nineteen patients were managed using this 2-stage procedure. Orbital implant exposure occurred 94.4 months (2–240) after implantation. The success rate was 68.4% (13/19) and failure rate 31.6% (6/19). Risk factors for exposure were enucleation for melanoma followed by radiation therapy, acrylic implant, and early exposure probably due to excessive suture tension. Discussion Implant exposure is the most common complication after evisceration, enucleation or socket surgery. Several techniques to repair exposures have been described. Two-stage Muller's muscle flap is an interesting option, especially for patients presenting defects larger than 4 mm 2 and without previous radiation therapy treatment. Conclusion The two-stage Muller's muscle flap procedure allows for an autologous vascularized pedicle flap from the ipsilateral upper eyelid. It is a reliable technique with a success rate of 68% in our study.