A case of anaerobic abscessed hydroxyapatite orbital implants

The purpose of this report is to document an unusual case of implant infection in a patient who had undergone enucleation and hydroxyapatite orbital implant surgery. A 32-year-old woman presented with chronic orbital discomfort and discharge following a history of hydroxyapatite orbital implant surgery at another hospital 4 years previous. She exhibited profuse discharge with a yellow, creamy color and marked conjunctival chemosis. Granulation tissue was noted on the central conjunctival surface. Following the removal of the conjunctival granulation tissue, a central 3x5 mm conjunctival dehiscence was present with exposure of the hydroxyapatite implant. A culture of purulent drainage emanating from the exposed implant showed a growth of Clostridium acetobutylicum. Removal of the orbital implant was done. The implant was noted to be filled with pus. This case suggests that anaerobic infection may be suspected when the granulation tissue is observed and a discharge with a foul odor is found.