A 49-year-old woman with a contracted and keratinized anophthalmic socket underwent a dermis-fat graft for orbital augmentation. She presented with an early ulcer on the surface of the dermis, with inhibited conjunctival growth. There was no improvement after 1 month of conservative treatment. The authors applied autologous serum eye drops to accelerate epithelial repair, with resolution of the ulcer and reduction of surface keratin within 3 weeks. This is the first report of dermis-fat graft ulcer treated with autologous serum.