Ocular injury secondary to periorbital use of stainless-steel wire and suture

R. P. Yeatts, J. Harvey, G. B. Bartley and J. J. Nerney
Department of Ophthalmology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC.

OBJECTIVE: To describe previously unreported ocular injuries from stainless-steel wire or suture used for facial skeletal or soft-tissue repair. PARTICIPANTS: Three patients who underwent orbital reconstruction (n = 2) or ptosis repair with excision of the orbiculus oculi (n = 1) were referred with signs and symptoms of ocular injury. INTERVENTIONS: Removal of the wires and sutures. RESULTS: Treatment resolved discomfort and irritation and diminished ocular motility, iritis, and bullous keratopathy but did not improve diminished vision in one of the patients. CONCLUSIONS: Occult ocular injury from misdirected or migrating stainless-steel wire should be considered in any case of ocular injury following orbital fracture or reconstructive repair when other disease processes are readily excluded. In these three cases, stainless-steel wire or suture impinged against or impaled the globe. The use of rigid plate fixation for orbital reconstruction or otherwise placing all stainless-steel wires and sutures outside the confines of the orbit would avoid such ocular injury.