An Inflammatory Reaction to Stored Fascia Lata 37 Years Postimplantation

Area of Science:

• Ophthalmology
• Plastic Surgery
• Immunology

Background:

• Congenital ptosis repair often utilizes autografts or allografts.
• Stored fascia lata is a common allograft material for frontalis suspension procedures.

Observation:

• A 39-year-old woman developed delayed, tender eyelid and forehead swelling 37 years post-fascia lata sling placement.
• Symptoms mirrored the location of the original allograft slings.

Findings:

• Histopathology revealed a non-necrotizing granulomatous inflammatory infiltrate with asteroid bodies.
• The reaction was initially managed with oral prednisone but required long-term methotrexate for recurrent inflammation.

Implications:

• This case suggests a potential for rare, delayed inflammatory reactions to allogeneic fascia lata.
• It raises questions about the long-term efficacy of sterilization techniques for donor tissues.
• Further investigation into latent reactions to allografts is warranted.