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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

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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.

Keywords:

Case report Scanning electron microscope-energy dispersive spectroscopy Silicone-induced orbital granuloma

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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.