A 25-year-old gentleman presented to us with an unstable prosthesis on the right side. He was diagnosed to have right eye secondary glaucoma with ciliary staphyloma at the age of 8 years for which he underwent an enucleation with 18-mm PMMA implant. Six years later, he developed post-enucleation socket syndrome with a shallow of inferior fornix. He was operated for fornix formation over three sittings in the postoperative period over the next 11 years; however, he had recurrent shortening of the fornix. On examination, there was lower eyelid laxity with shallow inferior fornix and a grade 2 SSD. The implant was migrated in the inferotemporal quadrant and palpable anterior to the inferior orbital rim. He underwent a PSI placement in the inferotemporal quadrant. This was followed by a fornix formation suture with mucus membrane graft for surface expansion. A COP was fabricated and dispensed 6 weeks thereafter. Over the next 20 months, both the implants remained stable and so did the inferior forniceal depth. There was a posterior movement of the spherical implant in the z-axis along with its centration in the orbit following the placement of PSI [].
A 43-year-old lady presented to us with complaints of frequent fall of the prosthetic eye from the left eye socket since the past 4 years. She had undergone an evisceration for panophthalmitis followed by secondary implant for volume augmentation 10 years ago. On examination, she had a sunken appearance of the prosthesis with a grade IV SSD and a 4-mm enophthalmos on the left side. There was inferotemporal implant migration with a shallow fornix. She underwent a PSI placement that helped center the migrated spherical implant. The fornix deepened after PSI placement. However, the SSD persisted for which she had a filler injection. Over a follow-up period of 15 months there were no complications noted with either implants. The fornix remained deep thereafter.