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Abstract Contracted socket has been typically referred to a socket with presence of deep scar formation associated with loss of orbital tissue fat and extensive loss of conjunctival surface area. Sometimes contracted socket may be caused due to shallow inferior fornix which has sufficiently loose conjunctiva which is not attached to the underlying tissue. The main purpose of socket reconstruction surgery to allow socket for adequate retention of prosthesis with a good motility to provide satisfactory cosmetic appearance to the patient. These includes surgeries that deepen the superior and inferior fornices with the help of substrate such as AMG, MMG and dermis fat graft and use of conformers or symblepharon ring to support the graft and prevent fibrosis Currently, oral mucosal membranes are the most commonly used grafts for socket reconstruction. The advantages of these grafts are; easily accessibility of grafts in sufficient size even for repeated procedures and a high stability. However, the use of buccal mucosa requires the availability of donor tissue, necessitates a long operation time and may result in a discomfort in the donor tissue site. In addition, oral mucosa may be associated with a color mismatch of the graft. Amniotic membrane has been frequently used for the reconstruction of the ocular surface. The amniotic membrane has a thick basement membrane and avascular stroma. It promotes the differentiation of the goblet cells and survival of conjunctival epithelium. AMT accelerates epithelialization, reduces inflammation, scarring and vascularization. The use of AMT is relatively straight forward and is not associated with iatrogenic trauma to the oral mucosa and is completed in a shorter time interval. The current study was performed to compare the efficacy of AMG and MMG in reconstruction of contracted eye socket. This meta-analysis included four studies that were published between 2006 and 2018. and about 72 patients with contracted eye socket participated in these studies. The findings of our study support the use of amniotic membrane grafting for the reconstruction of contracted eye socket. According to change in UF height, LF depth and volume of the eye socket. This study demonstrated a higher mean upper fornix among patients in AMG group compared to patients in MMG group with a higher mean difference of +1.08 mm in favour of AMG group which denotes success in AMG group and the overall effect is border line significant P=0.06 Also a higher mean lower fornix among patients in AMG group compared to patients in MM group with a higher mean difference of +0.99 mm in favour of AMG group which denotes success in AMG group and the overall effect is highly significant statistically. A higher mean volume among patients in AMG group compared to patients in MM group with a higher mean difference of +0.14 mm in favour of AMG group which denotes success in AMG group. and the overall effect is border line significant P=0.05 A lower percentage of complications in AMG group compared to MMG group. The overall percentage of complications in all the studies of AMG group 21.6% while in MMG group 26%. This denotes higher complications after operation in MMG group. with no significant difference statistically. P value >0.05. So the presented analytical study revealed that AMG achieves superior clinical results in comparison to the MMG in reconstruction of mild to moderate cases of contracted sockets regarding socket volume, and upper and lower forniceal widening. It also carries lower risk of complications. |