Surgical repair of orbital fat prolapse by conjunctival fixation to the sclera

Purpose: The aim of the study described here was to report the outcomes of surgery for orbital fat prolapse by conjunctival fixation to the sclera. Patients and methods: Twenty-three consecutive eyes of 19 patients with orbital fat prolapse were retrospectively reviewed. All cases were treated with the same simple procedure without resection through conjunctival incision: fixation of conjunctiva to the sclera with interrupted sutures of 10-0 nylon in two rows located approximately 12-14 mm posterior to the limbus. These sutures formed an embankment to keep the prolapsed fat posteriorly. Postoperative results were determined by slit-lamp examination and recurrence of prolapse was defined as the presence of orbital fat anterior to the embankment. Results: During the mean follow-up period of 19 months (range: 1-59 months), one case experienced recurrence which required further surgery. None of the other cases experienced recurrence, and there were no intraoperative or postoperative complications. Conclusion: Conjunctival fixation to the sclera was a simple and effective surgical technique for orbital fat prolapse, with less invasion compared to the conventional method that requires conjunctival incision.