Corneal astigmatism after cataract surgery

206 Consecutive cataract patients were at random divided into three groups according to the way the cataract incision was closed: virgin silk 8-0, interrupted nylon 9-0, and double running nylon 9-0. The nylon, whether interrupted or continuous, yielded in the majority of cases a postoperative astigmatism with the rule, whereas virgin silk caused in nearly all patients a postoperative astigmatism against the rule and therefore behaved like an absorbable suture. Silk is chemically non-absorbable, but in virgin silk a natural worm-produced polymer is still present, which provokes a tissue reaction. Softening of tissue diminishes the tensile strength of the suture. With respect to the postoperative astigmatism, the suture material (nylon or virgin silk) seems a more important factor than the way in which it is used (interrupted or continuous).