Delayed Orbital Abscess Following Orbital Floor Reconstruction With a PLLA/HA Implant

Area of Science:

• Ophthalmology
• Biomaterials Science
• Infectious Disease

Background:

• Orbital floor reconstruction commonly utilizes implants like poly-L-lactic acid/hydroxyapatite (PLLA/HA).
• Delayed complications are uncommon but can significantly impact patient outcomes.

Purpose of the Study:

• To report a rare case of delayed abscess formation following orbital floor reconstruction with PLLA/HA implants.
• To discuss potential contributing factors and management strategies for late implant-related infections.

Main Methods:

• Case presentation of a 49-year-old male with delayed diplopia and hyperglobus.
• Diagnostic imaging (CT/MRI) to evaluate the orbital lesion and implant.
• Surgical exploration, debridement, microbial culture, and histopathological analysis.

Main Results:

• A 49-year-old male developed a late orbital abscess 4 years after PLLA/HA implant surgery.
• Imaging revealed a displaced implant within an encapsulated lesion.
• Staphylococcus epidermidis infection was identified; surgical removal led to complete symptom resolution.

Conclusions:

• Late abscess formation is a rare but possible complication of PLLA/HA orbital implants.
• Factors such as implant degradation byproducts and patient comorbidities (diabetes, smoking) may contribute.
• Prompt surgical intervention and long-term monitoring are crucial for managing such cases.