Epithelial inclusion cyst associated with a porous polyethylene orbital floor implant

A 50-year-old man presented with reduced vision, hyperglobus, and an inferior orbital mass 3(1/2) years after the repair of an orbital floor fracture using a porous polyethylene (Medpor) implant. On funduscopy, the sclera was markedly indented. This was associated with retinal striae and a retinal pigment epithelial disturbance involving the macula. CT revealed a large inferior orbital cystic mass displacing the globe. The cyst was excised and the orbital implant was removed. Histologic findings were consistent with a respiratory epithelial inclusion cyst. Postoperatively, the vision improved and the hyperglobus resolved. The retinal striae and pigmentary disturbance persisted. Late capsule-related complications, such as epithelial cyst formation and intracapsular hemorrhage, have been reported in association with nonporous materials only. This case demonstrates that epithelial cyst formation may occur in association with a porous orbital floor implant and result in visual impairment.