Giant papillary conjunctivitis after keratoplasty

Giant papillae of the upper tarsal conjunctiva have been found in vernal conjunctivitis and, more recently, in giant papillary conjunctivitis in patients with contact lenses. A similar syndrome occurred in 11 patients who had undergone penetrating keratoplasty with interrupted nylon sutures. Minimal itching, mild mucous discharge, mild blepharoptosis, and giant papillae of the upper tarsal conjunctiva were associated with exposed suture ends. Removal of exposed sutures led to resolution of the condition. Conjunctival scrapings from three of five patients demonstrated eosinophils. Although the syndrome may have an immunologic basis, the findings are also consistent with a mechanical origin related to exposed nylon sutures.