안구 내 실리콘기름주입술 이후 발생한 위눈꺼풀의 지방육아종 염증 및 눈꺼풀처짐

Abstract

Purpose: We report a rare case of injected silicone oil migration into the upper eyelid, accompanied by lipogranulomatous inflammation and ptosis, after vitrectomy using a silicone oil tamponade. Case summary: An 83-year-old female presented to our clinic with left upper eyelid swelling and ptosis 2 months in duration. Five months prior, she had undergone 23-gauge pars plana vitrectomy combined with Ahmed valve implantation to treat neovascular glaucoma. Four months prior, only about half the original volume of intraocular silicone oil remained, and a second oil injection was thus administered after removal of the remaining original oil. We found a mass in front of the left orbital septum; this was associated with gradual progression of the left upper eyelid swelling and ptosis. We resected the mass via a left upper eyelid skin incision 2 months after presentation. Histological examination of the excised tissue revealed necrotic fat consistent with lipogranulomatous inflammation. One week after excision, the ptosis disappeared. At the 4-month follow-up, the left upper eyelid was normal with no sign of recurrence. Conclusions: To the best of our knowledge, this is the first report in South Korea of lipogranulomatous inflammation and ptosis induced by migration of injected silicone oil into the upper eyelid. Clinicians should be aware that swelling of the upper eyelid and a substantial decrease in the silicone oil level in the vitreous cavity, reflecting silicone oil leakage, maybe one of complications of vitrectomy.