Orbital silicone oil granuloma discovered during enucleation

[Traumatic optic pit-Optic nerve evulsion caused by indirect ocular trauma]

This article describes the case of a 28-year-old man who suffered an optic nerve evulsion (ONE) after falling from a height of 5 m. On admission visual acuity in the affected left eye was light perception, direct pupillary reaction was unresponsive, and the eye was hypotonic. Because of deep eyelid laceration, hyphemia and severe vitreous hemorrhage a globe rupture was suspected and a surgical exploration with vitrectomy was performed. This resulted in the detection of an ONE. During the following 24 months a painful eyeball due to secondary glaucoma developed and enucleation of the eye became necessary.

Orbital Leakage of Intraocular Silicone Oil: Case Reports and Literature Review

Silicone oil migration into the periorbital tissues occurs rarely after vitreo-retinal surgery and two cases are reported. The first case was a 48-year-old woman who presented with a blind painful right eye, upper eyelid swelling, and ptosis after multiple vitreo-retinal surgeries. Diffuse infiltration of silicone oil in the upper eyelid and anterior orbit was found during evisceration, mainly around the plate of a Baerveldt glaucoma valve. In the second case, a 69-year-old man with prior right scleral rupture underwent silicone oil tamponade for retinal detachment and presented with right upper eyelid swelling due to multiple silicone oil granulomas within the orbit. Open globe injury and glaucoma drainage devices both appear to facilitate extraocular migration of silicone oil that results in marked orbital infiltration and inflammatory response.

Extraocular silicone oil migration to orbit and retrolaminar region: case report and systematic review

BACKGROUND

Silicone oil insertion is a common modality in vitreoretinal surgeries. The purpose of this study is to conduct a systematic review to summarize the uncommon complication of extraocular silicone oil migration.

METHODS

Following the PRISMA guidelines, a systematic review of the literature was performed on January 11, 2020, using PubMed and EMBASE with the following terms: "silicone oil," "eye," and "migrat*."

RESULTS

A total of 69 patients-68 patients from 59 articles and one case from our institution-were included in the final analysis. The median age was 54 years (range, 9-92) and 40 patients (57.9%) were men. Orbital migration was reported in 34 patients, and retrolaminar migration (including optic nerve, optic chiasm, suprasellar, subarachnoid space, intraventricular spaces) was reported in 35 patients. Orbital migration group had more aphakics (p = 0.007), implanted glaucoma drainage device (p = 0.005), scleral buckle (p = 0.000), history of trauma-related indications for pars plana vitrectomy (p = 0.000), shorter silicone oil endotamponade time (p = 0.008), more symptomatic (p = 0.000), and requiring surgical intervention (p = 0.000). Retrolaminar migration group had older patients (p = 0.016) and more diabetics (p = 0.041).

CONCLUSION

Systematic review sheds light on plausible risk factors on site of silicone oil migration. Majority of orbital cases are symptomatic and require intervention while retrolaminar cases are incidental and can be managed conservatively. Awareness of this complication can help guide clinicians predict which patients would likely need surgical intervention. Graphical abstract.

Massive Silicone-Induced Orbital Granuloma

We report a large subconjunctival-orbital granuloma in a 51-year-old male presenting with a blind painful right eye and marked chemosis 15 months after undergoing vitrectomy and silicone oil retinal tamponade for retinal detachment with no reported intraoperative complications. Gross and histopathologic examination of the enucleated eye and episcleral tumor revealed a bosselated mass measuring 17 × 10 × 5 mm containing prominent vacuoles with surrounding epithelioid histiocytes and foreign body multinucleated giant cells. Such a large silicone-induced orbital granuloma following uncomplicated retinal surgery in a grossly intact eye has not been previously reported to the authors' knowledge. High intraocular pressure and emulsification of oil may facilitate silicone extravasation through scleral wounds after retinal surgery.

Migration of intraocular silicone oil from the vitreous cavity into the upper eyelid causing ptosis

Introduction

To report a case in which intraocular silicone oil migrated into the upper eyelid and caused ptosis.

Methods

A 65-year-old woman presented with proliferative vitreoretinopathy in the right eye. Vitrectomies, injection of silicone oil and encircling were performed. Two months after the last operation, swelling of her right eyelid occurred.

Result

Magnetic resonance imaging revealed moisture in the palpebral fat tissue. We incised the bulbar conjunctiva and confirmed silicone oil leakage from the vitreous cavity through the scleral button hole of the encircling suture. Postoperatively, the right upper eyelid swelling decreased. Histopathologically, dense macrophage infiltration was seen in the palpebral tissues.

Conclusions

We report a rare case with a postoperative complication caused by silicone oil. In cases with swelling of the eyelid and decreased silicon oil in the vitreous cavity postoperatively, clinicians should consider the possibility of silicone oil leakage.