Nylon suture toxicity after cataract surgery

A cluster of symptoms and signs that appear to be related to wound closure developed in 10 of 105 consecutive patients (9.5%) who underwent uncomplicated planned extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens (PC IOL) implants. These signs and symptoms included foreign body sensation, conjunctival injection and infiltrates localized to the scleral wound, and scleral excavation underlying the running 10-0 nylon suture possibly resulting from localized scleral edema. The clinical presentation ranged from 1 to 6 weeks. Conjunctival stains demonstrated eosinophils and polymorphonuclear leukocytes in some cases. Gram stains, conjunctival cultures, and results of suture toxicology studies were negative. The authors believe that these findings represent a previously unreported complication after ECCE: acute inflammation primarily localized to the conjunctiva and sclera adjacent to the cataract wound. The etiology of this postoperative complication is yet to be determined.