Long-term outcome of conjunctival fixation sutures to the sclera for prolapsed subconjunctival orbital fat

Differences in patient characteristics between subconjunctival herniated orbital fat in the superotemporal quadrant and the other quadrants: An observational study

Subconjunctival herniated orbital fat (SHOF) usually occurs in the superotemporal quadrant, and SHOF located in other quadrants is extremely rare. This study aimed to compare the patient characteristics between patients with SHOF in the superotemporal quadrant and those with SHOF in other quadrants. This is a retrospective study of 45 patients with SHOF who were referred to our institution between January 2015 and January 2023 and 14 previously reported patients in published case reports of SHOF that were not located in the superotemporal quadrant. Data on patient age, sex, affected sides, and body mass index were collected from the medical records of our institution and from previous reports. Patient age, male-to-female ratio, unilateral-to-bilateral ratio, and body mass index were compared between patients with SHOF in the superotemporal quadrant and patients with SHOF in the other quadrants. Of the 45 patients, only 1 patient showed SHOF in a location other than the superotemporal quadrant (inferonasal quadrant). Based on a comparison of 44 patients with SHOF in the superotemporal quadrant and 15 patients with SHOF in the other quadrants, the latter entity predominantly occurred in young, non-obese females (P < .050). Unilateral cases were more common in SHOF in the other quadrants (P = .003). Patient characteristics were found to be different between cases of SHOF in the superotemporal quadrant and those with SHOF in the other quadrants.

Long-Term Outcomes of a Surgical Technique in Management of Subconjunctival Orbital Fat Prolapse

Objective This retrospective, single-center, interventional study presented the long-term results of a novel surgical technique for the management of subconjunctival orbital fat prolapse. Methods Nine eyes of seven consecutive patients were surgically repaired using the technique involving connective tissue repair and were intended to be followed-up for more than five years. Results All surgeries performed were uneventful and esthetic enhancement was achieved for each patient. No postoperative complications were noted. There was no recurrence throughout the follow-up period; six eyes of four patients were followed-up for more than five years. Conclusions This technique with connective tissue repair achieved good long-term results.

Subconjunctival Orbital Fat Prolapse: An Update on Diagnosis and Management

Subconjunctival prolapse of orbital fat is an uncommon clinical entity in which intraconal orbital fat herniates into the subconjunctival space. Its diagnosis is mainly clinical in character and usually based on palpation, patient clinical history, and lesion features along with a slit lamp examination. Its pathophysiology remains unclear. Although frequently asymptomatic, clinical features may simulate conditions such as a prolapsed lacrimal gland, orbital lymphoma or dermolipoma and may worsen over time. In such cases, surgical removal or repositioning of the herniated fat may be necessary. While several surgical techniques have been described, no reports exist of a customized approach to manage this condition. This paper reviews the diagnosis and management of subconjunctival orbital fat prolapse.