Autologous Fat Graft for the Treatment of Sighted Posttraumatic Enophthalmos and Sunken Upper Eyelid

Purpose: The treatment of enophthalmos and sunken upper eyelid is challenging. Although autologous fat graft has been widely used in breast augmentation, buttock contouring, and facial rejuvenation, its application in enophthalmos and sunken upper eyelid is not yet widely utilized. The clinical safety and value of autologous fat graft in sighted patients with enophthalmos and sunken upper eyelid are unclear. This study retrospectively analyzed the cosmetic results and safety of autologous fat graft in the correction of sighted traumatic enophthalmos and sunken upper eyelid. Methods: Autologous fat graft was performed in 9 patients with posttraumatic enophthalmos and sunken upper eyelid. The visual acuity, orbital swelling, eye movement, enophthalmos, and sunken upper eyelid were observed. Results: Eight to 24 months after autologous fat graft, enophthalmos and sunken upper eyelid in 9 patients improved significantly. Although orbital swelling occurred in the early postoperative period, no vision loss, eye movement limitation, or fat embolism had occurred. Conclusion: Autologous fat graft is an effective, predictable, scarless, and minimally invasive surgery for the correction of the sighted posttraumatic enophthalmos and sunken upper eyelid. The possible risk of fat embolization and blindness from the compression of the optic nerve should not be neglected. Further studies and more cases must be performed. Accepted for publication October 14, 2017. Supported by the National Basic Research Program of China (973 Program, No. 2015CB554100), National Natural Science Foundation of China (No. 81271035/H1205), and Foundation for Returned Personals Studying Abroad from Human Resources Department of Sichuan Province in 2015, People's Republic of China. HC, QZ, and QQ are co-first authors. The authors have no conflicts of interest to disclose. Address correspondence and reprint requests to Hui Chen, M.D., Ophthalmology Department, Sichuan Provincial People's Hospital, No. 32, 1st Ring Road, 2nd West Section, Chengdu City, Sichuan 610072, People's Republic of China. E-mail: 540685790@qq.com; Zhenglin Yang, Ph.D., Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People's Hospital, No. 32, 1st Ring Road, 2nd West Section, Chengdu City, Sichuan 610072, People's Republic of China. E-mail: zliny@yahoo.com © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.