Periprosthetic bleeding 18 years post-silicone reconstruction of the orbital floor

Periprosthetic orbital haemorrhage is an uncommon complication of the alloplastic implants used in post-traumatic orbital floor repair. The small case series or individual reports provide no definite causative explanation for this delayed bleeding around silicone implants. It is likely that it is related to the disruption of fine capillaries within the pseudocapsule surrounding the implant, since the material does cause low-grade irritation with evidence of chronic inflammation.

We report the case of a patient who developed a spontaneous periprosthetic bleeding 18 years' post-silicone sheet reconstruction of the orbital floor.

Urgent removal of the implant insured prompt resolution of all symptoms and no further problem during the 2-year follow-up.

This report emphasizes that periprosthetic orbital haemorrhage can occur years after the initial repair. Awareness of this rare complication allows for prompt diagnosis, decreasing the possibility of permanent damage of the orbital content. The removal of implant is necessary to relieve the symptoms and prevent potential infective complications.