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Scleral Perforation Complicating Titanium Mesh Plaque in Orbital Blowout Fracture

Koktekir, Bengu Ekinci MD*; Bakbak, Berker MD*; Karamese, Mehtap MD; Gedik, Sansal MD*; Tosun, Zekeriya MD

Journal of Craniofacial Surgery: July 2012 - Volume 23 - Issue 4 - p 964–965
doi: 10.1097/SCS.0b013e31824e5c5d
Original Articles

A 27-year-old man who underwent a previous reconstruction surgery for left orbital blowout fracture and recent revision surgery for left cicatricial ectropion was admitted to the ophthalmology outpatient clinic with a 20-mm irregular conjunctival and scleral incision in the left eye at the 6-o’clock position. The scleral and conjunctival incisions were repaired, and during the operation, the anterior end of the titanium mesh plate was visible at the inferior orbital rim. The plastic surgery team removed the irritating end of the plate. Obvious adherence of periocular tissues onto the titanium implant and fibrovascular ingrowth through the implant were seen during this operation. The possible mechanism for the misdirection of the anterior end of the implant might be explained by iatrogenic rotation during the revision of the cicatricial ectropion. To the best of our knowledge, this is the first reported case demonstrating scleral incision caused by an orbital titanium implant.

denotes article available on Web site in Chinese translation

From the Departments of *Ophthalmology and †Plastic and Reconstructive Surgery, Selcuklu Faculty of Medicine, Selcuk University, Konya, Turkey.

Received November 11, 2011.

Accepted for publication January 2, 2012.

Address correspondence and reprint requests to Bengu Ekinci Koktekir, MD, Selcuk Universitesi, Selcuklu Tip Fakultesi, Goz Hastalıkları AD, Alaaddin Keykubat Kampusu, Selcuklu, Konya, Turkey; E-mail:

The authors report no conflicts of interest.

© 2012 Mutaz B. Habal, MD