A Case of Supraorbital Hypoesthesia Following Double Orbital Sphere Volume Implant

The patient is a 63-year-old female with past ocular history of end-stage glaucoma in her OD. To maintain symmetry and achieve cosmesis with her right orbit, she chose to proceed with enucleation of the eye with a donor sclera-wrapped 20-mm silicone sphere implant. After 1 year, she developed right enophthalmos due to volume loss. The patient opted for an additional sphere to be placed posterior to the original sphere. A 14-mm silicone sphere was placed through a lateral orbitotomy into the intraconal space. On postoperative day 1, the patient developed numbness along the V1 trigeminal nerve in the supraorbital region, extending past her hairline. The implant was removed 1 week later, and the authors are currently waiting for nerve recovery. This is a rare and challenging postoperative complication, possibly explained by nerve compression, demyelination, or nerve ischemia.