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Handheld Metal Detector Screening for Metallic Foreign Body Ingestion in Children
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Absorbable Implant Foreign Body Reaction Masquerading as Orbital Cellulitis
Gabrielle J Shaughness1, Kira L Segal, Alon Kahana
1Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor, Michigan, U.S.A.
Ophthalmic Plastic and Reconstructive Surgery
|November 16, 2018
Summary
Absorbable poly-DL-lactide implants for orbital fracture repair can cause late inflammatory reactions. Early steroid treatment resolved symptoms in a pediatric case, highlighting a rare complication.
Area of Science:
- Ophthalmology
- Biomaterials Science
- Plastic Surgery
Background:
- Poly-DL-lactide (PDLA) implants are increasingly utilized for orbital fracture repair due to their absorbable nature, typically degrading within 6-12 months.
- These implants offer a temporary solution for restoring orbital structure and function following trauma.
Observation:
- A 7-year-old boy experienced orbital inflammation 10 months after undergoing repair of a white-eyed blowout fracture using a PDLA implant.
- The patient presented with symptoms indicative of a foreign body inflammatory reaction.
Findings:
- The patient's symptoms rapidly improved following the initiation of oral steroid therapy.
- This swift clinical response strongly suggested a foreign body inflammatory reaction to the PDLA implant as the cause of the inflammation.
Implications:
- Ophthalmologists and orbital surgeons must recognize that absorbable implants, such as PDLA, can elicit late-onset, idiosyncratic inflammatory complications.
- Awareness of this potential complication is crucial for accurate diagnosis and timely management of post-operative orbital issues.
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