Sunil Warrier1, Venkatesh C Prabhakaran, Garry Davis, Dinesh Selva. 1. Oculoplastic and Orbital Division, Department of Ophthalmology and Visual Sciences, University of Adelaide and the South Australian Institute of Ophthalmology, Adelaide, Australia. sirkneel@yahoo.com
Abstract
PURPOSE: To report a series of patients who developed late complications secondary to silicone implants used in orbital fracture repairs and review the literature. DESIGN: Retrospective interventional case series. METHODS: Analysis of records of patients who developed complications following repair of orbital wall fractures with silicone implants. RESULTS: Over a 5-year period, 4 patients were seen with complications arising from a silicone orbital implant. There were 3 males and 1 female whose ages ranged from 41-73 years. The time interval between initial insertion of implant and development of complications was 1.5, 6, 10, and 20 years. The complications noted were worsening diplopia, recurrent orbital cellulitis, lower lid retraction with restricted upgaze, and orbital abscess. Computed tomographic scans demonstrated the implant in all cases. Histologic examination revealed nonspecific chronic inflammation and fibrosis in all cases and foci of squamous epithelium in one case. Treatment included surgical removal of the implant, resulting in complete resolution or significant improvement in symptoms and signs in all cases. CONCLUSION: The use of silicone implants is associated with a wide range of complications, which may occur many years following the original surgery. Surgical removal of the implant usually leads to resolution of symptoms. Given the potential of silicone implants to cause delayed complications, their use in orbital fracture repair is not recommended.
PURPOSE: To report a series of patients who developed late complications secondary to silicone implants used in orbital fracture repairs and review the literature. DESIGN: Retrospective interventional case series. METHODS: Analysis of records of patients who developed complications following repair of orbital wall fractures with silicone implants. RESULTS: Over a 5-year period, 4 patients were seen with complications arising from a silicone orbital implant. There were 3 males and 1 female whose ages ranged from 41-73 years. The time interval between initial insertion of implant and development of complications was 1.5, 6, 10, and 20 years. The complications noted were worsening diplopia, recurrent orbital cellulitis, lower lid retraction with restricted upgaze, and orbital abscess. Computed tomographic scans demonstrated the implant in all cases. Histologic examination revealed nonspecific chronic inflammation and fibrosis in all cases and foci of squamous epithelium in one case. Treatment included surgical removal of the implant, resulting in complete resolution or significant improvement in symptoms and signs in all cases. CONCLUSION: The use of silicone implants is associated with a wide range of complications, which may occur many years following the original surgery. Surgical removal of the implant usually leads to resolution of symptoms. Given the potential of silicone implants to cause delayed complications, their use in orbital fracture repair is not recommended.