Delayed complications of silicone implants used in orbital fracture repairs.
OBJECTIVE
To report a series of patients who developed late complications secondary to silicone implants used in orbital fracture repairs and review the literature.


METHODS
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.


CONCLUSIONS
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.
Warrier
Sunil
S
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
Prabhakaran
Venkatesh C
VC
Davis
Garry
G
Selva
Dinesh
D
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015331:Cohort Studies; D020878:Device Removal; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000379:methods; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009917:Orbital Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D020273:Orbital Implants / Q000009:adverse effects*; D016459:Prosthesis-Related Infections / Q000473:pathology* / Q000628:therapy; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods; D012086:Reoperation; D012189:Retrospective Studies; D012826:Silicone Elastomers / Q000009:adverse effects*; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents; D012826:Silicone Elastomers