Abstract

Introduction: Orbital contracture is a severe cicatricial process within the enucleated orbit prohibiting the use of an ocular prosthesis and often requires socket expansion procedures. We hypothesize that the RFFF provides stable long-term expansion of the contracted orbit and allows for continued ocular prosthesis use without the accumulation of keratin debris. Methods: A retrospective chart review was performed at the University of Iowa Hospitals and Clinics. Results: Two subjects with orbital contracture were identified. Both had previously undergone tissue graft orbital expansion and failed. RFFF reconstruction was performed without complication. Nine and 10 years after reconstruction both patients maintain well-formed sockets without contracture recurrence. Both subjects were able to use an ocular prosthesis without keratin debris accumulation. Conclusions: The radial forearm free flap provides durable, long-term orbital expansion that definitively corrects orbital contraction and is not associated with adverse consequences such as the accumulation of keratin debris.

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