Retained strabismus suture material masquerading as nonspecific orbital inflammation

Area of Science:

• Ophthalmology
• Inflammatory Diseases

Background:

• Orbital inflammation can present with varied etiologies, often mimicking other orbital conditions.
• Strabismus surgery, while common, can have long-term complications, including foreign body reactions.

Observation:

• A patient presented with orbital myositis of the superior rectus muscle-levator complex.
• The inflammation was localized to the site of a braided polyester "chicken suture" placed 20 years prior for strabismus surgery.
• The condition was refractory to oral steroid treatment.

Findings:

• The orbital inflammation was directly attributable to the retained "chicken suture" material.
• Surgical excision of the suture led to prompt resolution of the orbital myositis.
• This represents the first reported instance of deep, diffuse orbital inflammation caused by a "chicken suture" from strabismus surgery.

Implications:

• Retained "chicken sutures" from strabismus surgery can cause delayed, deep orbital inflammation.
• Surgical removal of inciting suture material is an effective treatment for such refractory orbital myositis.
• Ophthalmologists should consider long-term suture material complications in cases of unexplained orbital inflammation.