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Alexandre Robin, Jean Luc George, Toufik Maalouf, Karine Angioi-Duprez; Foreign Body Granulomas After Fadenoperation: About 6 Cases. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6374.
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Quality of strabismus surgery is mostly evaluated through angular results. Scar tissue complications after fadenoperation, especially foreign body granulomas are rarely evoked in the literature. The aim of our study was to evaluate and to describe our cases of granulomas and granulation tissue after fadenoperation, their possible risk factors and their treatment.
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.
Six children (3 to 10 years old) were included. Incidence of granuloma is at 1,55 . All the children, who developped granulomas were operated of fadenoperation surgery combined with medial rectus recession. Delay of granulomatous formation occurence were variable ranging from 5 months to 5 years. All the patients underwent surgical treatment of granulomatous formations. Three cases of new recurrence after initial surgical excision occured
Granulomatous formations in fadenoperation can be attributed to Mersuture ® suture. Non resorbable suture, ischemia induced by fadenoperation and surgery traumatism may lead to subclinical granuloma. Suture extrusion, cause or consequence of granulomatous phenomenon could explain late delay of clinical expression. All of our patients are children as the single publication reporting two cases of granulomas after fadenoperation and others studies reporting cases of « teddy bears granulomas ». Despite surgical treatment, 3 recurrences occured, probably linked to exogenous material persistence within the surgical site. Respect of tenon’s ring and muscular structures respect could be a way to prevent scar tissue complications in fadenoperation
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