Introduction: Alloplastic implants are commonly used for reconstruction of orbital wall defects. Post-operative complications include hemorrhage, infections, and the formation of periprosthetic orbital cysts, which can lead to removal of the implant. We consider it necessary to strategically remove the cyst wall and add a counterpore in the maxillary sinus to prevent recurrence of the cyst.
Case description: We report the case of a patient who suddenly developed a periprosthetic multi-row columnar epithelial cyst 12 years after initial orbital floor reconstruction using a silicone sheet implant. Although the implant was immediately removed and the cyst was extirpated, followed by complete clinical recovery, the cyst redeveloped one year after surgery. We extirpated the cyst again and no further complications were noted at the 2-year follow-up.
Conclusion: This report emphasizes that periprosthetic orbital cysts can develop years after the initial repair. Awareness of this rare complication enables prompt diagnosis, reducing the risk of permanent damage to the orbit. Complete extirpation of the cyst and removal of the implant are necessary to relieve the symptoms and prevent recurrence of the cyst. In the case of incomplete removal of the cyst, it is essential to create a drainage pathway into the maxillary sinus to prevent further damage as much as possible.
