The use of allotransplant from the subcutaneous fat with plantar aponeurosis for the musculoskeletal stump formation during enucleation

Objective. To develop a method for the formation of a musculoskeletal stump for an ocular prosthesis during enucleation using an allograft from subcutaneous fat with a plantar aponeurosis was developed Methods. The study included patients with the diagnosed choroid melanoma (n=15), and retinoblastoma (n=2). The orbital cavity was replenished with the section of subcutaneous adipose tissue with the sole aponeurosis, preserved by cryopreservation. The orbital cavity was filled with a section of subcutaneous adipose tissue with plantar aponeurosis, preserved by cryopreservation. The immediate effect was assessed 3 and 6 months after the treatment according to the following criteria: the presence of the orbital tissues edema, the mobility of the supporting stump with the prosthesis, the position of the stump with the prosthesis in the orbit, and the position of the upper eyelid. Results. In all cases, a positive result was obtained: after 3 months, the orbital tissue edema was absent in 7 patients, in 7 - it was mild, in 3 - it was moderately pronounced. After 6 months, the orbital tissue edema was absent in all patients. After 3 months the mobility of the supporting stump was moderately marked in 10 patients, and in 7 - it was feeble marked. After 6 months, the mobility of the stump was marked moderately in all patients. After 3 months in 7 patients, the position of the stump with the prosthesis had a symmetrical position; there was hypereffect in 10 patients. By 6 months, all patients had a symmetrical arrangement of the healthy eye and prosthesis. Conclusion. The designed method for the formation of the functional stump for an ocular prosthesis during enucleation using the allograft from subcutaneous fat with the plantar aponeurosis makes it possible to obtain good anatomical, cosmetic and functional results of the operation due to the achievement of a sufficient rangeofprosthetic movement of the ocular prosthesis. The introduction of the designed method of the functional stump formation into clinical practice increases the medical, social, economic efficiency of the rehabilitation of patients with malignant neoplasms of the eyeball membranes. What this paper adds For the first time, a method for the formation of a musculoskeletal stump for an ocular prosthesis during enucleation using an allograft from subcutaneous fat with a plantar aponeurosis was developed. It is shown that the allograft application makes it possible to obtain a good anatomical, cosmetic and functional result by achieving a sufficient rangeofprosthetic movement of the eye prosthesis.