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Massive Silicone-Induced Orbital Granuloma
Ann Shue1, Jeffrey M Joseph1, Jeremiah P Tao1
1Gavin Herbert Eye Institute, University of California, Irvine, Irvine, California, USA.
Ocular Oncology and Pathology
|April 8, 2020
Summary
A large silicone-induced orbital granuloma developed 15 months after retinal surgery. This rare complication, involving a silicone oil granuloma, highlights potential risks even after uncomplicated procedures.
Area of Science:
- Ophthalmology
- Pathology
Background:
- Silicone oil is used for retinal tamponade in complex retinal detachments.
- Complications from silicone oil, though uncommon, can occur postoperatively.
- Subconjunctival-orbital granulomas are rare but serious adverse events.
Purpose of the Study:
- To report a unique case of a large subconjunctival-orbital granuloma.
- To investigate the histopathological features of a silicone oil-induced orbital granuloma.
- To discuss potential mechanisms for silicone extravasation after retinal surgery.
Main Methods:
- Case report of a 51-year-old male with a blind, painful eye.
- Gross and histopathological examination of an enucleated eye and episcleral mass.
- Analysis of a 17 × 10 × 5 mm bosselated mass with silicone vacuoles and giant cells.
Main Results:
- A large subconjunctival-orbital granuloma was identified 15 months post-vitrectomy.
- Histopathology revealed epithelioid histiocytes and multinucleated giant cells around silicone vacuoles.
- No intraoperative complications were reported during the initial retinal surgery.
Conclusions:
- This is the first reported case of such a large silicone-induced orbital granuloma after uncomplicated retinal surgery.
- High intraocular pressure and silicone oil emulsification may contribute to extravasation.
- Ophthalmologists should be aware of this rare but significant potential complication.
