Unburied polytetrafluoroethylene scleral suture erosions and failure of pericardial graft revision.

Purpose: The purpose of this case series is to report three cases of exposed, unburied polytetrafluoroethylene (Gore-tex) sutures used for scleral fixated intraocular lenses and their management, including failure of pericardial patch and success of irradiated corneal patch. This series aims to inform management options for this uncommon adverse event. Observations: A retrospective case series was conducted of three patients who presented at a tertiary care center with exposure of unburied Gore-tex sutures used for fixation of intraocular lens. All three patients underwent initial suture revision with pericardial graft patching. Chart review was conducted to assess past ocular history, operative technique for lens fixation surgery, time from this surgery to suture exposure, time to pericardial patch failure, and long-term outcome.Results showed that pericardial patch grafting failed within several months in all three cases. One patient subsequently had an irradiated corneal graft placed and still had a successful outcome after 36 months of follow-up. Possible risk factors for suture erosion were identified as a surgical history of pterygium excision and loose or unburied suture knots. Conclusions and importance: Pericardial patch grafting may not work well for unburied Gore-tex suture exposure. Eyes with prior complex histories are at risk for erosion of unburied Gore-tex sutures with surgical repair required.