Complete porous polyethylene orbital implant expulsion following primary enucleation for uveal melanoma: a case report
Author: Andreas Kreis
Base Hospital / Institution: Jules Gonin Eye Hospital, Lausanne, Switzerland
ePoster presentation
Abstract ID: 24-226
Purpose
To report a case of a complete porous polyethylene spherical (Medpor©) orbital implant expulsion after primary enucleation for choroidal melanoma.
Methods
A 61-year-old female patient underwent primary enucleation (LE) because of a large choroidal melanoma complicated by a hemorrhagic retinal detachment. An orbital glide was used for deep implantation of the spherical implant. Ten days later, the patient presented with orbital cellulitis, with a conjunctival swab positive for Staphylococcus aureus. She was treated with intravenous and oral antibiotics as well as antihistamine, antibiotic and steroid drops. MRI excluded an orbital abscess. The orbital swelling resolved gradually, and an esthetic prosthesis was finally adapted 11 weeks following enucleation. Nevertheless, the patient continued to complain about itching and conjunctival secretions, without orbital pain nor swelling, and for which no satisfactory treatment could be identified.
Results
Finally, 14.5 months following enucleation, the orbital implant was spontaneously expelled from the anophthalmic socket, without prior visible implant exposure. Interestingly, the implant was free from any fibrovascular ingrowth. Although a deep orbital implantation technique was performed, a possible gradual tissue restitution process may have contributed to the conjunctival breach potentiated by persistent inflammation.
Conclusion
We describe a rare complication of spontaneous porous polyethylene orbital implant expulsion following primary enucleation for uveal melanoma despite the use of a glide. Further studies are needed to investigate the mechanisms of implant expulsion.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Julien | Schaller | Jules Gonin Eye Hospital, Lausanne, Switzerland |
| Ann | Schalenbourg | Jules Gonin Eye Hospital, Lausanne, Switzerland |
| Barbara | Spahn | Jules Gonin Eye Hospital, Lausanne, Switzerland |
| Augustina | Grigaité | Department of Ophthalmology, University Hospitals of Geneva, Geneva, Switzerland |
