Giant papillary conjunctivitis in connection with corneoscleral supramid (nylon) suture knots

A material consisting of 27 patients had corneoscleral wound closure by 8-0 polyamide (supramid, nylon) sutures after intracapsular cataract extraction and intraocular lens implantation. A few months after surgery 16 patients had developed giant papillary conjunctivitis of the upper tarsus of the operated eye, associated with itching and blurring. The earlier stages of the condition, as described by other authors, could be defined in the remaining 11 patients. Cytologic tests - pipette samples of tear fluid and tarsal conjunctival scrapings - demonstrated eosinophil leucocytes and neutrophilia in most of the giant papillary conjunctivitis cases. The conjunctival scraping proved the more sensitive test for detection of eosinophils, the pipette test being mainly an indicator of inflammatory reaction. The condition seems to be allergic with an element of mechanical irritation. The use of polyamide sutures of the 8-0 size is not recommended.