To the Editor.
—The posterior fixation suture operation was initially described by Cuppers1 in 1974 as a treatment for nystagmus blockage syndrome.More recent reports have indicated the operation's usefulness in treating dissociated vertical deviation, convergence-excess esotropia, Duane's syndrome, Brown's syndrome, double elevator palsy, face turns associated with nystagmus, and incomitant vertical strabismus. Structural changes in the muscle after this operation have been described in detail, but only in animal models.2We report herein the clinical and pathologic findings in two patients in whom the complication of suture granulomas developed after placement of posterior-fixation sutures.
—An 8-month-old boy was brought to our clinic with an alternating esotropia and nystagmus that had been noted since birth. A diagnosis of esotropia with nystagmus compensation was made. At the age of 15 months, a 5-m medial rectus recession with a posterior fixation, polyfilament surgical suture (5-0
Gal A, France TD. Granuloma Formation as a Complication of the Posterior Fixation Suture Operation. Arch Ophthalmol. 1986;104(12):1755. doi:10.1001/archopht.1986.01050240029011
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