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• W2106564706 abstract "We were pleased to read Dr. Rubin and associate’s positive experience with acellular dermal allografts in their oculoplastic applications.1Rubin P.A.D. Fay A.M. Remulla H.D. Maus M. Ophthalmic plastic applications of acellular dermal allografts.Ophthalmology. 1999; 106: 2091-2097Abstract Full Text Full Text PDF PubMed Scopus (105) Google Scholar Our experience using acellular dermal allografts in 87 cases over the past 2 years parallels their findings and recommendations with a few exceptions. We also found some unpredictability in the persistence rate of the grafts when used in the upper eyelid compared with the lower eyelid. We presume this to be due to increased micromotion in the upper eyelid that may limit early vascularization of the graft, thus leading to increased resorption. There may be a role for adjunctive botulinum-induced eyelid akinesia for upper eyelid applications if secondary ptosis would not be a problem for the patient (i.e., anophthalmia). We have not noticed any difference in graft resorption related to the orientation of the basement membrane relative to the skin surface when using it for deeper augmentations. In contrast to Dr. Rubin’s series, one of our early anophthalmic patients developed a postoperative infection that required removal of the graft in the lower eyelid. The patient subsequently did well with another graft staged 3 months later. We have found additional uses for acellular dermis not listed in Dr. Rubin’s article such as covering high-density polyethylene or bone grafts in the periorbital area to help minimize submuscular adherence syndromes. These cases often had posttraumatic subcutaneous and orbicularis muscle atrophy and benefited from further soft tissue augmentation. Another excellent application is for the correction of overaggressive blepharoplasty with resultant supratarsal fold hollowing or asymmetry. In these cases supratarsal volume is needed to correct asymmetric eyelid creases and contours. Submuscular placement of the dermal allograft helps reconstruct the supratarsal fold (see Fig 1). We have also found acellular dermal collagen useful in the correction of skeletization of the orbital rim from midfacial descent (tear-trough deformity). The volume and persistence seem superior to orbital fat. Acellular collagen grafts have not been particularly helpful in lower eyelid retraction repair except in those cases in which you need only provide some separation or spacer between the capsulopalpebral fascia and the inferior tarsal margin without semirigid vertical support. We commend the authors on an excellent review of their experience with this relatively new and exciting tissue technology and look forward to publications of longer term follow-up and additional insights." @default.
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• W2106564706 date "2000-11-01" @default.
• W2106564706 modified "2023-09-26" @default.
• W2106564706 title "Application of acellular diurnal allografts" @default.
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• W2106564706 doi "https://doi.org/10.1016/s0161-6420(00)90238-0" @default.
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