Abstract:

 Objective To study the clinical features and the effectiveness of the treatment of the epithelial inclusion cysts associated with alloplastic implants after orbital fracture repair. Design Retrospective case series. Participants The study collected 7 patients with epithelial inclusion cysts after orbital fracture treated in Beijing Tongren Hospital between 2005 and 2017. Methods The data including demographic characteristics, site of fracture, implant used, interval between implantation of material and presentation of the orbital cyst, clinical presentation, treatment, histological examination of the cyst and follow up findings were collected and analyzed. Main Outcome Measures The clinical features and treatment results. Results 6 cases were males in all 7 patients, with a mean age of 35.0±3.8 years. There were 5 cases associated with hydroxyapatite compound materials, one case associated with silastic material, and another one associated with titanium meshwork. Orbital cysts developed between 20 months and 11 years after implantation. The clinical presentations in all cases included proptosis, restricted ocular mobility, diplopia, hyperglobus, and reduced visual acuity. The cysts were excised in all cases. The implants were completely removed in 4 cases. Histological analysis confirmed that the cysts were all lined with respiratory cells. After operation, the symptoms were relieved in all cases, no recurrence was noted. Conclusions Epithelial inclusion cyst is a rare and late complication after orbital fracture repair, which may present with various symptoms. Complete excision of the cyst wall with removal of the implants might be the best treatment to relief symptom and prevent recurrence. (Ophthalmol CHN, 2019, 28: 307-311)

Key words: orbital fracture, epithelial inclusion cysts, complication