Dermis-fat graft (DFG) is often the only promising option in casesof severely contracted sockets. However, there is an increased riskof graft failure in irradiated sockets with decreased vascularity.In such difficult cases, repeat DFG implantation also has higherrisks of graft failure.We describe an ingenious method of successful managementof an irradiated anophthalmic socket following DFG infection andnecrosis, with acceptable cosmetic results. At surgery, an orbitalimpression was taken with ophthalmic grade alginate. Based onthis measurement, a custom-made stem pressure socket-expandermade up of high density polymethyl methacrylate (PMMA) wasfitted, a week post surgery and kept in situ for six weeks.On review, the fornices had considerably deepened. Theexpander device was removed and the patient was now fittedwith a custom-made thicker prosthesis made up of high-densityPMMA. The patient has followed up for a year subsequently andthe prosthesis has remained stable.Keywords: Contracted socket, socket expansion, stem pressure socket-expander
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