Malpositioned orbital implants: indications for implant removal and secondary reconstructive techniques.
Double vision improved or resolved in most patients after revision orbital implant surgery
Malpositioned orbital implants: indications for implant removal and secondary reconstructive techniques.
Malpositioned orbital implants are an underappreciated source of significant postoperative morbidity, often necessitating revision surgery.
To analyze clinical presentations, radiographic failure patterns, multidisciplinary surgical strategies, and outcomes of patients undergoing revision surgery for malpositioned orbital implants.
A single-center retrospective consecutive case series was conducted of patients who underwent removal or replacement of malpositioned orbital implants.
Five of seven patients (71.4%) were female, with a median age of 60 years (range 29-78).
Diplopia was the most common presenting symptom (5/7, 71.4%) along with pain or swelling (5/7, 71.4%) followed by globe malposition (3/7, 42.9%).
CT demonstrated implant protrusion into orbital soft tissue in 4/7 patients (57.1%) and peri-implant inflammatory collections in 3/7 (42.9%).
Out of our 7 revision cases, four patients (57.1%) underwent explantation alone, and three (42.9%) underwent secondary reconstruction with custom or semi-custom implants.
Malpositioned orbital implants demonstrate heterogeneous failure mechanisms that require individualized surgical management.
A multidisciplinary approach can guide decision-making regarding implant removal versus revision of reconstruction, enabling safe revision surgery and favorable clinical outcomes.
Additionally, virtual surgical planning and intraoperative navigation are enablers of safe and precise revision orbital surgery.