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There is limited literature describing complications at the limbal suture site. The authors describe two cases with postoperative complications due to use of intraoperative limbal stay sutures. Each case had strabismus surgery at other centres but with presentation to the author’s centre due to complications. Ages at presentation were 12 and 76 years. The first case had strabismus surgery two years previously and presented with whitish intrastromal corneal opacity with the stalk based at the limbus and with a scalloped leading edge. The patient was asymptomatic with no effect on visual acuity over a follow-up period of eight years. The second case had strabismus surgery three days earlier and presented with corneal infiltrate with anterior chamber cells, flare and vitritis. A diagnosis of endophthalmitis was made. The patient developed localised subconjunctival abscess immediately below the area of corneal infiltrate. Visual acuity reduced to counting fingers. The abscess was drained and antibiotics given. Visual acuity improved to 6/30 and the cornea healed with localised pannus. As a result of these cases, the authors now include potential visual loss as a complication of strabismus surgery within the consent process. They suggest avoidance of limbal stay suture complications by use of alternative methods of globe traction or, if using stay sutures, to place them immediately peripheral to the limbus and avoiding the cornea, with use of monofilament sutures.

Complications of limbal stay sutures in strabismus surgery.
Kuruvilla SE, Pater J, Taranath D.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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