Our Summary

This research paper discusses a rare case of a type of non-cancerous skin growth called pyogenic granuloma, which developed nearly 40 years after a patient had eye surgery. A 58-year-old man who has HIV came in for an evaluation due to a possible cancerous growth in his eye. The patient noticed the growth about a month and a half prior to the visit and it had grown significantly in the last month. His only known injury to the eye was having surgery to fix a detached retina 37 years ago.

On examination, doctors found a pink, fleshy growth in the eye, which looked like it was coming from the upper-inner part of the eye. They used a high-resolution imaging technique that revealed a dense, reflective mass. Further investigation of the growth found a white, stringy, cauliflower-like material underneath it. After removing it surgically, further analysis confirmed it as a pyogenic granuloma, which was caused by leftover silk stitches from the previous surgery.

The paper concludes that doctors should consider the possibility of pyogenic granuloma due to leftover stitches in patients who have had eye surgery, regardless of other risk factors or how much time has passed since the surgery.

FAQs

  1. What is pyogenic granuloma and how does it relate to eye surgery?
  2. How can leftover stitches from previous eye surgeries lead to the development of pyogenic granuloma?
  3. What are the symptoms of pyogenic granuloma and how is it diagnosed?

Doctor’s Tip

A helpful tip a doctor might tell a patient about scleral buckle surgery is to follow all post-operative instructions carefully, including taking any prescribed medications, attending follow-up appointments, and avoiding activities that could put strain on the eye. It is important to report any unusual symptoms or changes in vision to the doctor promptly to ensure proper healing and prevent complications.

Suitable For

Patients who have had previous eye surgery, especially those with a history of detached retina repair, are typically recommended scleral buckle surgery. This procedure involves placing a silicone band around the eye to support the retina and prevent further detachment. Patients who have experienced retinal detachment, have a high risk of developing it again, or have other retinal issues may be recommended scleral buckle surgery to stabilize the retina and improve vision. Additionally, patients with severe eye trauma or certain eye conditions such as myopia (nearsightedness) may also benefit from scleral buckle surgery to prevent retinal detachment.

Timeline

Before scleral buckle surgery:

  1. Patient experiences symptoms of a detached retina, such as sudden flashes of light, floaters, or a curtain-like shadow over their vision.
  2. Patient consults with an ophthalmologist who confirms the diagnosis of a detached retina and recommends scleral buckle surgery.
  3. Patient undergoes pre-operative testing and evaluation to assess their overall eye health and determine the best course of treatment.
  4. Surgery is scheduled, and the patient is informed about the procedure, risks, and expected outcomes.

After scleral buckle surgery:

  1. Patient undergoes scleral buckle surgery, where a silicone or plastic band is placed around the eye to support the retina and prevent further detachment.
  2. Patient may experience some discomfort, redness, and swelling in the eye immediately after surgery.
  3. Patient is given post-operative instructions, including how to care for their eye, use prescribed medications, and when to follow up with their ophthalmologist.
  4. Over the following weeks and months, the patient will attend follow-up appointments to monitor their eye healing and check for any complications.
  5. Patient’s vision gradually improves as the retina reattaches and stabilizes, with the goal of restoring as much vision as possible.
  6. Patient may need additional treatments or surgeries if complications arise or if the retina does not fully reattach.
  7. Patient continues to have regular eye exams to monitor their eye health and ensure long-term success of the surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about scleral buckle surgery include:

  1. What is scleral buckle surgery and why is it recommended for my condition?
  2. What are the potential risks and complications associated with scleral buckle surgery?
  3. What is the success rate of scleral buckle surgery in treating a detached retina?
  4. How long is the recovery process after scleral buckle surgery and what can I expect during this time?
  5. Will I need to follow any specific post-operative care instructions or restrictions after the surgery?
  6. Are there any long-term effects or potential complications I should be aware of following scleral buckle surgery?
  7. What alternative treatment options are available for my eye condition, if any?
  8. How often will I need to follow up with you after the surgery for monitoring and evaluation?
  9. What is the likelihood of developing complications such as pyogenic granuloma after scleral buckle surgery?
  10. Are there any specific signs or symptoms I should watch out for that may indicate a complication or issue with the surgery?

Reference

Authors: Zein M, Theotoka D, Wall S, Galor A, Cabot F, Patel U, Dubovy S, Karp CL. Journal: Cornea. 2021 Oct 1;40(10):1357-1359. doi: 10.1097/ICO.0000000000002637. PMID: 34481413