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Suture reaction masquerading as a conjunctival malignancy.

Hak Sung Chung1, Robert S Feder, Bonnie C Weston

  • 1Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.

Canadian Journal of Ophthalmology. Journal Canadien D'Ophtalmologie
|June 13, 2006
PubMed
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A retained suture after ptosis surgery can mimic conjunctival malignancy. Careful examination, potentially with anesthesia, is crucial for identifying these occult foreign bodies and avoiding unnecessary procedures for suspected conjunctival tumors.

Area of Science:

  • Ophthalmology
  • Ophthalmic Pathology
  • Surgical Complications

Background:

  • Conjunctival lesions can present with varied etiologies.
  • Ptosis surgery involves the use of various suture materials.
  • Differentiating neoplastic from inflammatory conjunctival lesions can be challenging.

Observation:

  • A superior bulbar conjunctival lesion in the right eye was initially suspected to be a malignancy.
  • The patient had a history of prior ptosis surgery.
  • A thorough examination under anesthesia revealed an occult polypropylene suture within the conjunctiva.

Findings:

  • Histologic examination of the excised lesion showed only chronic inflammatory cells, not neoplastic cells.
  • The conjunctival inflammation was secondary to the retained suture fragment.

Related Experiment Videos

  • The clinical presentation mimicked conjunctival malignancy.

    • Implications:

    • Suspicious conjunctival lesions in patients with a history of ptosis surgery warrant a high index of suspicion for retained sutures.
    • Detailed examination, including manipulation of conjunctival tissues under anesthesia, may be necessary to detect occult foreign bodies.
    • Prompt identification and removal of retained sutures can prevent misdiagnosis and inappropriate treatment of presumed conjunctival neoplasms.