Korean J Ophthalmol.  2006 Dec;20(4):234-237. 10.3341/kjo.2006.20.4.234.

A Case of Orbital Abscess following Porous Orbital Implant Infection

• Hong SW
• Paik JS
• Kim SY
• Yang SW

• KMID: 754589
• DOI: http://doi.org/10.3341/kjo.2006.20.4.234

Abstract

PURPOSE: We present a case of orbital abscess following porous orbital implant infection in a 73-year-old woman with rheumatoid arthritis. METHODS: Just one month after a seemingly uncomplicated enucleation and porous polyethylene (Medpor(R)) orbital implant surgery, implant exposure developed with profuse pus discharge. The patient was unresponsive to implant removal and MRI confirmed the presence of an orbital pus pocket. Despite extirpation of the four rectus muscles, inflammatory granulation debridement and abscess drainage, another new pus pocket developed. RESULTS: After partial orbital exenteration, the wound finally healed well without any additional abscess formation. CONCLUSIONS: A patient who has risk factors for delayed wound healing must be examined thoroughly and extreme care such as exenteration must be taken if there is persistent infection.

Keyword

Porous orbital implant infection; Orbital abscess; Partial orbital exenteration

MeSH Terms

Prosthesis-Related Infections/diagnosis/*etiology/surgery
Porosity
Orbital Implants/*adverse effects
Orbital Diseases/diagnosis/*etiology/surgery
Magnetic Resonance Imaging
Humans
Follow-Up Studies
Female
Eye Enucleation
Device Removal
Aged
Abscess/diagnosis/*etiology/surgery

Figure

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  Fig. 1 T1-weighted, gadolinium enhanced horizontal magnetic resonance imaging of the brain and orbits, showing myositis in all four rectus muscles, and an abscess pocket between the medial wall and medial rectus muscle (arrow).

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  Fig. 2 Profuse pus discharge one month after removal of dermofat graft.

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  Fig. 3 T1 weighted, gadolinium enhanced horizontal magnetic resonance imaging of the brain and orbits 2 months after removal of dermo-fat graft. All four rectus muscles were removed. Previous abscess pocket was resolved, but new abscess pocket developed (arrow).

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  Fig. 4 Partial exenterated orbital tissues were removed from socket.

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  Fig. 5 Histologic findings from the inflammatory tissue specimen after partial exenteration shows active inflammation and fibrosis. An aggregate of mature lymphocytes is seen in fibrous tissue and collagen bundles, but no evidence of microorganisms was found (hematoxylin and eosin stain ×100).

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  Fig. 6 Final follow-up. The wound site was well resolved, and no inflammation or signs of infection were found.

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