[Supposed nylon allergy after cataract surgery]

We present the case of a patient operated on for extracapsular cataract extraction of both eyes. Three weeks after the first operation (right eye), the patient presented a local inflammatory reaction at the incision site which was characterized by the existence of whitish exudates of different sizes surrounding the nylon suture. At one week of the second operation, the patient presented the same alteration (left eye), although it was observed sooner and had a greater intensity. The allergy skin tests for nylon and other substances were negative, however the local inflammatory reaction disappeared when the nylon suture was removed.

This type of reaction, which we have observed in several other patients, has been previously described by others authors, although no clearly established cause has been demonstrated. Both toxicity and allergy to nylon have been proposed as the underlying mechanisms. We consider that a type IV hypersensitivity reaction to nylon may be the underlying mechanism of these reactions although toxicity cannot be ruled out.