Globe Fixation Caused by Intraocular Migration of an Orbital Floor Implant

A 30-year-old male presented with diplopia 1 month after implantation of an orbital floor plate for a blowout fracture. The orbital plate was removed 3 months later, however, the fixation bar was left in place as it had migrated full thickness through the inferior oblique muscle, sclera, choroid, and retina. After 5 years of head tilt, the patient was referred to our department with a metallic intraocular foreign body visible in fundo and an important elevation deficit. CT imaging confirmed our clinical suspicion of a retained fixation bar. The extraocular part of the fixation bar was removed via a transconjunctival inferior orbitotomy, leaving the intraocular part in place due to the high risk of ocular complications upon removal. Postoperative ocular motility improved greatly and the patient no longer experiences diplopia in daily life. Orbital plate migration is a rare complication that should be considered in de novo diplopia after orbital reconstruction.

Automated summary

A 30-year-old male presented with diplopia 1 month after orbital floor plate implantation for a blowout fracture. The orbital plate was later removed, but the fixation bar was left due to its full thickness migration through multiple ocular tissues. After 5 years, the patient was referred to our department and a retained fixation bar was confirmed. The extraocular part was surgically removed, while the intraocular part was left in place due to the risk of ocular complications upon removal. Postoperatively, the patient's ocular motility significantly improved and diplopia was resolved in daily life.