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J Cosmet Med 2017; 1(2): 95-99
Published online December 31, 2017
Late complications of nylon suture blepharoplasty causing ocular surface injury
Kazunami Noma, MD, PhD1, Yasuhiro Takahashi, MD, PhD2, Maria Suzanne Sabundayo, MD2, Hirohiko Kakizaki, MD, PhD2
1Noma Eye Clinic, Hiroshima, Japan, 2Aichi Medical University Hospital, Nagakute, Japan
Correspondence to :
Hirohiko Kakizaki, Aichi Medical University Hospital, 1-1 Yazako-Karimata, Nagakute 480-1195, Japan
Tel: 81-561-62-3311, Fax: 81-561-76-0822, E-mail: cosme@d1.dion.ne.jp
© Korean Society of Korean Cosmetic Surgery
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: There are several known ocular complications of suture blepharoplasty which includes suture exposure, cyst formation, and surgical site infection.
Objective: To present late complications of nylon suture blepharoplasty that causes damage to the ocular surface.
Methods: Medical records of patients who developed ocular surface injury at least 1 year after nylon suture blepharoplasty were reviewed.
Results: A total of 9 eyes (3 right and 6 left) of 9 patients (all females) were included in this study. All patients underwent trans-tarsal nylon suture blepharoplasty. The average age of the patients was 36.2 years (range: 22-64 years). The average interval between suture blepharoplasty and revision surgery was 9.6 years (range: 5-15 years). The mean follow-up period after revision surgery was 17 months (range: 7-48 months). Before revision surgery, all patients had reported ocular discomfort. Slit lamp examination revealed ocular surface injury caused by the presence of granulation tissue in the palpebral conjunctiva and deformity of the tarsal plate. Intraoperatively, suture exposure was absent in all but one eyelid. All of the symptoms completely disappeared postoperatively.
Conclusion: Late complications of nylon suture blepharoplasty such as granulation tissue formation and tarsal plate deformity cause damage to the ocular surface. The trans-tarsal technique and hydrolytic denaturation of nylon sutures were considered as the main contributory factors leading to the mechanisms of ocular surface injury.
Level of Evidence: Level IV, case series
Keywords: suture blepharoplasty, ocular surface injury, granulation tissue, nylon, trans-tarsal technique
- Chen WPD. Suture ligation methods. In: Chen WPD, editor. Asian blephraoplasty and the eyelid crease. 2nd ed. Philadelphia:Butterworth-Heinemann; 2006. p. 39-50.
- Sakai S. [Juuken-jutsu: maibotsu-hou]. In: Nemoto Y, editor. Practical ophthalmology 99: meno Keiseigeka. Tokyo: Bunkodo;2003. p. 70-4. Japanese.
- Tsurukiri K. New modified double eyelid technique to avoid corneal damage. J Jpn Aesth Plast Surg 1997;19:87-93.
- Baek SM, Kim SS, Tokunaga S, Bindiger A. Oriental blepharoplasty:single-stitch, nonincision technique. Plast Reconstr Surg 1989;83:236-42.
- Choi Y, Eo S. Tissue thread grafting: nonincisional doubleeyelid operation. Ann Plast Surg 2010;64:376-80.
- Homma K, Mutou Y, Mutou H, Ezoe K, Fujita T. Intradermal stitch blepharoplasty for orientals: does It disappear? Aesthetic Plast Surg 2000;24:289-91.
- Azuma T, Hirayama T, Misumi Y, Uesugi H, Ideta I. Anastomotic aneurysm due to fragmentation of monofilament polyamide suture (Nylon 6-66). Jpn J Vasc Surg 2007;16:619-23.
- Laroche G, Marois Y, Schwarz E, Guidoin R, King MW, P?ris E, et al. Polyvinylidene fluoride monofilament sutures: can they be used safely for long-term anastomoses in the thoracic aorta? Artif Organs 1995;19:1190-9.
- Mizuno T. Treatment of suture-related complications of buriedsuture double-eyelid blepharoplasty in Asians. Plast Reconstr Surg Glob Open 2016;4:e839.
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Original Article
J Cosmet Med 2017; 1(2): 95-99
Published online December 31, 2017 https://doi.org/10.25056/JCM.2017.1.2.95
Copyright © Korean Society of Korean Cosmetic Surgery.
Late complications of nylon suture blepharoplasty causing ocular surface injury
Kazunami Noma, MD, PhD1, Yasuhiro Takahashi, MD, PhD2, Maria Suzanne Sabundayo, MD2, Hirohiko Kakizaki, MD, PhD2
1Noma Eye Clinic, Hiroshima, Japan, 2Aichi Medical University Hospital, Nagakute, Japan
Correspondence to:Hirohiko Kakizaki, Aichi Medical University Hospital, 1-1 Yazako-Karimata, Nagakute 480-1195, Japan
Tel: 81-561-62-3311, Fax: 81-561-76-0822, E-mail: cosme@d1.dion.ne.jp
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: There are several known ocular complications of suture blepharoplasty which includes suture exposure, cyst formation, and surgical site infection.
Objective: To present late complications of nylon suture blepharoplasty that causes damage to the ocular surface.
Methods: Medical records of patients who developed ocular surface injury at least 1 year after nylon suture blepharoplasty were reviewed.
Results: A total of 9 eyes (3 right and 6 left) of 9 patients (all females) were included in this study. All patients underwent trans-tarsal nylon suture blepharoplasty. The average age of the patients was 36.2 years (range: 22-64 years). The average interval between suture blepharoplasty and revision surgery was 9.6 years (range: 5-15 years). The mean follow-up period after revision surgery was 17 months (range: 7-48 months). Before revision surgery, all patients had reported ocular discomfort. Slit lamp examination revealed ocular surface injury caused by the presence of granulation tissue in the palpebral conjunctiva and deformity of the tarsal plate. Intraoperatively, suture exposure was absent in all but one eyelid. All of the symptoms completely disappeared postoperatively.
Conclusion: Late complications of nylon suture blepharoplasty such as granulation tissue formation and tarsal plate deformity cause damage to the ocular surface. The trans-tarsal technique and hydrolytic denaturation of nylon sutures were considered as the main contributory factors leading to the mechanisms of ocular surface injury.
Level of Evidence: Level IV, case series
Keywords: suture blepharoplasty, ocular surface injury, granulation tissue, nylon, trans-tarsal technique
References
- Chen WPD. Suture ligation methods. In: Chen WPD, editor. Asian blephraoplasty and the eyelid crease. 2nd ed. Philadelphia:Butterworth-Heinemann; 2006. p. 39-50.
- Sakai S. [Juuken-jutsu: maibotsu-hou]. In: Nemoto Y, editor. Practical ophthalmology 99: meno Keiseigeka. Tokyo: Bunkodo;2003. p. 70-4. Japanese.
- Tsurukiri K. New modified double eyelid technique to avoid corneal damage. J Jpn Aesth Plast Surg 1997;19:87-93.
- Baek SM, Kim SS, Tokunaga S, Bindiger A. Oriental blepharoplasty:single-stitch, nonincision technique. Plast Reconstr Surg 1989;83:236-42.
- Choi Y, Eo S. Tissue thread grafting: nonincisional doubleeyelid operation. Ann Plast Surg 2010;64:376-80.
- Homma K, Mutou Y, Mutou H, Ezoe K, Fujita T. Intradermal stitch blepharoplasty for orientals: does It disappear? Aesthetic Plast Surg 2000;24:289-91.
- Azuma T, Hirayama T, Misumi Y, Uesugi H, Ideta I. Anastomotic aneurysm due to fragmentation of monofilament polyamide suture (Nylon 6-66). Jpn J Vasc Surg 2007;16:619-23.
- Laroche G, Marois Y, Schwarz E, Guidoin R, King MW, P?ris E, et al. Polyvinylidene fluoride monofilament sutures: can they be used safely for long-term anastomoses in the thoracic aorta? Artif Organs 1995;19:1190-9.
- Mizuno T. Treatment of suture-related complications of buriedsuture double-eyelid blepharoplasty in Asians. Plast Reconstr Surg Glob Open 2016;4:e839.
