Bilateral sterile sub-tenon abscess with vicryl suture reaction following strabismus surgery: A case report

• Published in: International journal of surgery case reports Vol. 120; p. 109850
• Main Authors: Neyaz, Hanan A., AlGhamdi, Ismail, A. Alsadhan, Ghadh, Alkharashi, Maan S
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.07.2024
• Subjects: Infection; Strabismus surgery; Sub-tenon; Vicryl; Infection; Strabismus surgery; Vicryl; Sub-tenon
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2024.109850

After strabismus surgery, infections and complications are uncommon but avoidable with the right aseptic measures. Rarely have cases of non-infectious sub-tenon abscesses been documented in the past; these cases need to be appropriately recognized and treated. In this report we describe a case of bilateral sub-tenon abscess 4 weeks after medial rectus recession. Despite receiving topical antibiotics for 7 days, there was no improvement, and multiple conjunctival cultures and sensitivity showed no growth. Both eye's sub-tenon abscess was drained, irrigated with gentamicin, and the fragile suture was removed. Sub-tenon abscess has been associated with bacterial infection which has more sever presentation. Several facts, including the lack of organisms in the pre-operative and intraoperative cultures, the presence of big cells resembling foreign bodies, and the improvement that occurred after suture extrusion, make infection unlikely in this case. We concluded that suture reaction is most likely to be responsible for a late-onset sub-tenon abscess with a negative culture and no response to antibiotics, and the suture should be removed. •Although they are infrequent, post-strabismus surgical infections can be rather dangerous.•Culture is required in sub-tenon abscesses to identify infectious etiology.•In cases with sterile abscess, removal of the suture is the best course of action.