Symptomatic cystic lesions as late post-operative complications of silicone implantation for orbital wall fracture reconstruction: A long-term follow-up study

Abstract

Although complications of silicone implants and development of new materials have led to a decline in the use of silicone implants for orbital wall fractures, their advantages are still reported. The overall incidence, risk factor and treatment of silicone implant complications, especially those caused by cystic lesions, remain unclear. We aimed to report our experiences of patients with orbital wall fractures that were reconstructed with silicone implants and followed up for a long period. We retrospectively analysed 56 patients who underwent surgical repair of the orbital wall fractures with a silicone implant from January 2006 to December 2017 and were followed up for more than 6 months. A chart review and the assessment of demographic and surgical factors, among others, were performed. There were 47 eligible patients in this study, and the mean post-operative follow-up period was 83.1 months. When comparing the results obtained 6 months post-operatively with those obtained at the final follow-up, the overall complication rate increased from 5/47 to 13/47, and the silicone implant removal rate increased from 0/47 to 10/47. The symptoms caused by the cystic lesions were managed through silicone implant removal. The immediate post-operative bleeding was significantly associated with silicone implant survival (p = 0.008). Silicone implants used for orbital wall fractures were never stabilised during the long-term study. Much attention should be paid during the follow-up of high-risk patients. Most late complications were caused by cystic lesions, and only silicone implant removal would be sufficient and considered safe as the initial intervention.