Use of DermaMatrix graft in oculoplastic surgery

Purpose: The use of acellular human dermal allografts has become widely accepted in oculoplastic surgery. However, the literature only describes the use of AlloDerm as the only source of acellular human dermis. The authors describe our experience using DermaMatrix in oculoplastic surgery. Methods: An institutional review board-approved retrospective chart review of 13 patients who received DermaMatrix grafts in either eyelid or anophthalmic reconstruction was performed. Only patients with at least 3 months follow-up were included. Procedures reviewed were eyelid reconstructive cases (i.e., lower eyelid retraction repair) and anophthalmic socket reconstructions. Success of the procedure was determined by improvement of symptoms (reduced need for eyelid lubrication, improved lagophthalmos, less subjective dryness) and by the anophthalmic patients' regained ability to wear a prosthesis. Failure was determined by the need for additional surgery to correct residual eyelid or socket abnormality. Results: Nine patients had lower eyelid retraction due to facial palsy, thyroid eye disease, or craniofacial abnormality. Three patients had contracted anophthalmic sockets and were unable to wear prostheses. One patient had squamous cell carcinoma involving the entire upper eyelid, and DermaMatrix graft was used to recreate the tarsus in the Cutler-Beard flap. Ten of the 13 patients had successful outcomes as denoted by improved symptoms. Three patients underwent further surgery; of these, 2 patients had a significant history of trauma and facial reconstruction. The third patient with surgical failure had lower eyelid retraction on upgaze that was likely due to aberrant regeneration. Conclusions: DermaMatrix graft is a viable alternative to AlloDerm in oculoplastic surgery. Some advantages to DermaMatrix are less maintenance (no need to refrigerate and rehydrates quickly intraoperatively) and ease of surgical manipulation.