Immortal plain gut sutures: A case report

PURPOSE: We report the case of a 79-year-old male who presented with irritation and foreign body sensation due to the subconjunctival plain gut sutures that did not dissolve three years after undergoing pars plana vitrectomy (PPV) for macular hole repair. OBSERVATION: A 79-year-old male presented with foreign body sensation and irritation in his left eye. On slit lamp examination, the source of the foreign body sensation was two apparently intact plain gut sutures were visible under the conjunctiva, nasal and temporal to the cornea. These plain gut sutures were placed at the conclusion of PPV surgery three years prior to presentation. After discussion, the patient elected suture removal, and two thin, translucent suture fragments were removed. Histopathologic evaluation revealed eosinophilic dense collagenous material with frayed edges, compatible with gut suture, associated with rare macrophages and scant fibrous tissue. CONCLUSION AND IMPORTANCE: The sclerotomies created for PPV occasionally need to be sutured at the conclusion of surgery to ensure wound closure, to retain tamponade, or to reduce endophthalmitis risk. Plain gut sutures have been shown to cause less scleral inflammation and to improve patient comfort compared to Vicryl sutures. However, in this case the plain gut sutures had not dissolved three years after PPV and had caused discomfort for patient and needed to be removed.