An unusual complication of malar augmentation: transconjunctival exposure and scleral erosion

The purpose of this report is to bring the attention of ophthalmologists to a lesser-known complication of bilateral transconjunctival exposure and scleral erosion caused by malar implant migration. A 26-year-old man presented with severe pain in left eye, worsening on attempted eye movement. His history included a road accident 1 year back, following which he had undergone bilateral malar implant placement. Examination revealed an implant that had migrated superiorly and breached the inferior forniceal conjunctiva, leading to scleral erosion. Exploration was carried out and the implant trimmed so as to clear it well off the orbital rim. Two weeks later, the patient presented with similar clinical features in his right eye. Debulking of the implant was then done on right side as well. The patient was relieved of his symptoms with free and painless extraocular movements after the procedure.