Efficacy of transconjunctival excision of orbital fat prolapse: a long-term follow-up study

PURPOSE: To describe the long-term efficacy of transconjunctival excision of subconjunctival orbital fat prolapse.

METHODS: Retrospective study of consecutive cases of orbital fat prolapse treated with transconjunctival resection between December 2002 and December 2011.

RESULTS: Thirty-two eyes of 23 patients (19 males and four females) were included. The lesion was unilateral in 14 and bilateral in nine cases. It was located superotemporally in a majority of cases. Excision was performed by opening the conjunctiva and excising the prolapsing orbital fat. The conjunctival wound was closed with 1-2 interrupted sutures. With an average follow-up of 29 months (range 4-108), a recurrence was seen in three cases. The average time to recurrence was 46 months (range 40-52 months).

CONCLUSION: Transconjunctival excision is a simple, safe and effective primary surgical procedure to treat subconjunctival fat prolapse. In our series, the recurrence rate was 9%, but no additional surgery was required. As the average time to recurrence was longer than our average follow-up, more patients may develop a recurrence in future.