Changing thresholds for cataract surgery.
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Biomedical subjects
Publications and source records attributed to R Bosanquet.
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The load bearing and deformation characteristics of monofilament nylon 66 have been examined. This material has been shown to have increased strength and altered deformation properties compared to bulk nylon. These features are beneficial in its role as a corneal suture. However, the load bearing performance of monofilament nylon 66 has been shown to be influenced by the manner in which it is stressed, making the task of producing identical stitches difficult. Moreover, a period of rapid relaxation has been shown to occur immediately after installation which makes the time taken to install the suture a critical factor in its subsequent performance. These factors, which are essentially beyond the control of the ophthalmic surgeon, must surely play a significant role in the inconsistent post operative results seen.
A short pilot study is described which investigates some of the mechanical properties of ophthalmic sutures. The Alcon 10/0 monofilament nylon suture was found to behave in a mechanically consistent manner. Like all nylon it possesses the property of 'creep', which helps to compensate for overtightening of the section during surgery.
Three groups of patients who had undergone cataract extraction through a corneal incision closed with 10/0 nylon sutures one, two, and three years previously were recalled to determine the incidence of suture related complications. Broken corneal sutures were found in 87.5% of patients after two years and 90% after three years and were causing symptoms in over half the patients. It is recommended that 10/0 nylon corneal sutures be routinely removed no later than one year after surgery.
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