Rigid nylon foil-anchored polytetrafluoroetyhlene (Gore-Tex) sheet stenting for conjunctival fornix reconstruction.

Purpose: To describe an operative technique that deepens foreshortened conjunctival fornices by providing a scaffold for epithelialization that opposes contractile forces during wound healing.

Design: Retrospective interventional case series.

Participants: Seventeen patients with anophthalmic sockets containing foreshortened conjunctival fornices.

Methods: Conjunctival fornices was reconstructed with stents of expanded polytetrafluoroethylene (e-PTFE) sheet draped over rigid, 0.8-mm thick-nylon strips that were anchored to the orbital rim. Preoperative and postoperative symptoms, prosthesis retention, fornix depth, and lagophthalmos were assessed.

Main Outcome Measures: Prosthesis retention, fornix depth, and lagophthalmos.

Results: All 17 patients had preoperative inability to retain their prosthesis. After postoperative follow-up of 47+/-43 months, retention was improved in all patients and was entirely satisfactory in 15 (88%) patients. After reconstruction, the repaired fornix was deep in 7 (41%) patients, adequate to retain a prosthesis in 9 (53%), and shallow in 1 (6%). Lagophthalmos improved in 15 (88%) patients and remained unchanged in 2 (12%). The superior fornix was reconstructed concurrently with the inferior fornix in 6 patients. In these patients, the superior fornix improved to deep (3 patients; 50%) or adequate (2; 33%). In 1 (17%) patient, it remained shallow.

Conclusions: Rigid, nylon foil-anchored e-PTFE stenting opposes postoperative contracture, improving prosthesis retention, and lagophthalmos. It does not require an additional surgical site for graft harvesting.