Why would pyogenic granuloma develop and how do you treat it?
Pyogenic granuloma (Fig. 10) may develop for several reasons including exposed sclera or subconjunctival tissue, suture induced trauma, residual fibrovascular tissue, large mass of fibrin glue left, and/or lack of good contact with the MMC soaked sponge during incubation. One can avoid this complication by fully covering the bare sclera with amniotic membrane using fibrin glue without sutures, by making sure there is full contact between the caruncle tissue and the MMC sponge by pushing caruncle down during MMC incubation time via 0.12 forceps, and by carefully monitoring inflammation of the host conjunctival tissue at one month postop visit. If pyogenic granuloma develops, one can increase PF to q2h for one or two weeks. Once the stalk is not congested, it can simply be excised in the office.
