Removal of Silicon-associated Intraorbital Cyst with Gingival Sulcus Incision

ABSTRACT

PURPOSE: Alloplastic implants, such as Silastic(R) , Supramid(R) , Porous polyethylene, Teflon(R) have been used to prevent reherniation of orbital tissue and are known to be inert for many years, though complications are infrequently reported many years after their insertion. Complications associated with implants are infrequent, but infection, orbital hemorrhage, implant extrusion, motility restriction, migration of implant causing dacryocystitis, cystic formation have been described. The latter was known as a rare late complication of blow-out fracture repair. METHODS: We report the case of a discovery of a intraorbital hemorrhagic cyst which developed after silicon implant insertion. This patient developed diplopia, unilateral proptosis, exophthalmos, vertical dystopia, ectropion 10 years after repair of blow-out fracture. In this case, orbital CT scan revealed intraorbital cyst surrounding the orbital implant. At surgery, a fibrous capsule surrounded the silicon implant and was filled with mucin pools. RESULTS: Proptosis, diplopia, exophthalmos, ectropion, vertical dystopia were resolved after surgical removal of the cyst and implant. CONCLUSION: This case illustrate that it is important for us to be aware of the complication of cyst formation around the silicon implants.