Migration of Silicone Oil into the Orbit and Eyelid as a Cys
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A 7-year-old female was referred to the clinic due to left upper eyelid swelling and mass-like lesion after pars plana deep vitrectomy and silicone oil injection due to penetrating eye surgery 1 year before admission. On ophthalmologic examination, left eye visual acuity was counting fingers at 20 cm; the retina was attached, and the eye was filled with silicone oil. On external examination, the left upper eyelid had mechanical ptosis. On palpation, there was a mobile mass in the lateral portion of the left upper eyelid.

Orbital computed tomography scan was performed and showed multiple well-defined masses, isodense with silicone oil in vitreous, in the left upper eyelid. The lateral mass was larger than the medial ones and seemed lobulated. There were also 2 abnormal isodense masses with silicone oil in the intraconal space of the left orbit (Fig. 1). It was decided to perform a transcutaneous excisional biopsy for eyelid masses. Eyelid biopsy showed cystic lesions, which were solid and translucent (Fig. 2). The largest one was 10 × 18 mm in diameter. Complete excision of globules was done, and the skin was sutured by nonabsorbable suture.

Histopathology showed foreign-body reactions to the cysts of silicone oil (Fig. 3). The patient was followed up after 1 week for suture removal; no sign of recurrence was observed, and the mechanical ptosis was significantly improved. It is recommended to remove intraocular silicone oil as soon as possible and to follow-up the patient who retained silicone oil for an extended period of time more frequently. The extraocular silicone oil was manifested as a mass with mechanical ptosis in the current case; hence, it is recommended to be suspicious of silicone oil migration in patients with a history of vitreoretinal surgery and silicone oil injection if the patient complains of eyelid swelling, ptosis, or mass postoperatively.

Source:https://www.karger.com/Article/FullText/507608
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