Acquired Brown Syndrome as a Postoperative Complication of Orbital Wall Fracture Repair with Metallic Mesh.

Surgical repair of orbital fractures comes with risks. One rare risk is interference with the actions of the superior oblique tendon-muscle complex causing an acquired Brown syndrome. We present the case of a 45-year-old man who developed acquired Brown syndrome after undergoing repair of a large orbital floor and medial orbital wall fracture using a titanium mesh implant. A case report was prepared to discuss a rare surgical risk with open reduction internal fixation (ORIF) of an orbital wall fracture. A retrospective chart review was performed. Post-operative ophthalmological assessment revealed persistent diplopia along with limitations of up-gaze particularly in the adducted position. Ultimately, the patient underwent surgical repositioning of the orbital implant, which seemingly released the superior oblique muscle-tendon complex, resolving most of the diplopia. No further treatment with prisms or strabismus surgery has been required. Acquired Brown syndrome is a potential risk of surgical repair of orbital fractures involving the medial orbital wall. Herein this case study, we describe a case of acquired Brown syndrome following ORIF of an orbital floor and medial wall fracture, which was alleviated with a revision surgery.