Foreign body granuloma's after fadenoperation : a review of seven cases

Abstract Purpose To evaluate and to describe our series of foreign body granulomas and granulation tissue after fadenoperation. Methods Retrospective monocentric study, from 1997 to 2010, conducted on all the patients who developed a foreign body granuloma or a foreign body granulation tissue histologically proven, after fadenoperation surgery. Results Seven patients (3 to 10 years old) were included. Incidence of granuloma is evaluated at 1,95 ‰ among all our surgeries of strabismus. All the patients were children. All had been operated of fadenoperation surgery combined with medial rectus recession. Delay of granulomatous formation occurence ranged from 5 months to 5 years. All the patients underwent surgical treatment of granulomatous formations with pathological analysis. We have observed three cases of recurrence after initial surgical removal. Conclusion Non resorbable suture, ischemia induced by fadenoperation and surgery traumatism may lead to development of subclinical granulomas. Suture extrusion, cause or consequence of granulomatous phenomenon could explain late delay of clinical expression. Granulomas occurred always when both of recession and fadenoperation were realized. This can be explained by increased local inflammation and maybe by the presence of two kinds of suture. Despite surgical treatment, 3 recurrences occured, probably linked to exogenous material persistence within the surgical site. To reduce and to prevent the occurrence of granulomas, using a resorbable suture may be interesting.