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[Insufficiency of a frontalis loop]

J M Rohrbach1, V Herzau, T M Wohlrab

  • 1Universitäts-Augenklinik Tübingen, Abteilung I (Allgemeine Augenheilkunde mit Poliklinik.

Klinische Monatsblatter Fur Augenheilkunde
|March 1, 1997
PubMed
Summary

A Terylene frontalis loop excised after 13.5 years showed giant cell reaction. Insufficiency was likely due to subclinical foreign body reaction or mechanical stress on the suture material.

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Area of Science:

  • Ophthalmology
  • Biomaterials Science
  • Surgical Pathology

Background:

  • Terylene (polyethylene terephthalate) frontalis loops are used for eyelid surgery.
  • Assessing the long-term in vivo performance and tissue response to implanted surgical materials is crucial.

Observation:

  • A 2-0 Terylene frontalis loop was explanted after 13.5 years due to functional insufficiency.
  • Histological examination revealed a persistent giant cell reaction with a notable absence of lymphocytes.
  • Suture fibrils remained intact but were separated by ingrowing connective tissue.

Findings:

  • The ingrowing connective tissue suggests potential functional improvement of the frontal muscle.
  • The loop's insufficiency was attributed to a subclinical foreign body reaction or chronic mechanical stress.
  • Giant cell reaction indicates a persistent inflammatory response to the implanted Terylene material.

Implications:

  • Understanding long-term foreign body reactions is vital for biomaterial selection in ophthalmic surgery.
  • Chronic mechanical stress can lead to tissue damage and implant failure, even with intact suture material.
  • This case highlights the complex interplay between biomaterial degradation, host tissue response, and mechanical forces in long-term implants.

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