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We describe an unusual case of implant exposure with epithelial downgrowth into the scleral pouch following evisceration. The patient’s clinical course and treatment as well as a histologic analysis of the excised scleral pouch are detailed. Excision of the implant and scleral pouch followed by diamond-shaped dermis-fat graft replacement was eventually required. The internal aspect of the sclera was completely covered with nonkeratinized stratified squamous epithelium. Epithelial downgrowth following evisceration is a rare complication that should be considered when orbital implant exposure occurs or when cysts overlying the sclera are discovered. Epithelial downgrowth needs to be adequately treated to allow for successful socket reconstruction and ocular prosthesis retention.
Ghaiy R, Meyer DR, Farber MA. Epithelial Downgrowth Complicating Evisceration With Orbital Implant Exposure. Arch Ophthalmol. 2005;123(9):1268–1270. doi:10.1001/archopht.123.9.1268
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