Granuloma after sling surgery: an attempt to answer the ‘why’ and ‘what to do next’

Abstract

The granuloma is primarily due to exposure of the sling itself or the sleeve enveloping the sling or the suture tied around the sleeve thereby. They do not respond to antibiotics but respond very well to explantation. These patients can be taken up for re-sling surgery after a waiting period of 3 months.

Infected conjunctival pyogenic granuloma at strabismus surgery site mimicking conjunctival abscess

“…Formation of granuloma could be due to the infectious organisms 9 . Foreign materials used in eye surgery has resulted in non-infective granulomas 10 . Suture material can also cause delayed complication including granuloma after ophthalmic surgery 11 .…”

Pediatric Blepharoptosis

“…8,19,20 Cable suture slings, such as Prolene or nylon, are particularly susceptible to recurrence; therefore, they are primarily indicated as temporary treatment to prevent amblyopia in severe ptosis. [20][21][22] Expanded polytetrafluoroethylene (ePTFE) is a synthetic porous fluoropolymer with a low recurrence rate 23,24 and an infection rate between 7% and 45.5%. 20,23 Silicone provides the benefits of easy reversibility and increased elasticity, which decreases the risk of lagophthalmos (►Fig.…”

“…[20][21][22] Expanded polytetrafluoroethylene (ePTFE) is a synthetic porous fluoropolymer with a low recurrence rate 23,24 and an infection rate between 7% and 45.5%. 20,23 Silicone provides the benefits of easy reversibility and increased elasticity, which decreases the risk of lagophthalmos (►Fig. 1).…”

“…12 In terms of autologous materials, preserved fascia lata is less commonly used due to high recurrence rates and the possible risk of transmitting infectious diseases. 20,26 Autologous fascia lata, on the other hand, is considered the gold standard for treatment. Due to its low complication and recurrence rate, it is deemed the best for long-term correction (►Figs.…”

“…18,19 Additionally, rapid integration with surrounding tissue may hinder attempts at revision, and resorption may limit long-term success rates. 8,20 As a result, achieving appropriate eyelid height fixation intraoperatively is critical when using autologous fascia lata. Autologous temporalis fascia has been used as an alternative and has demonstrated similar rates of success.…”