Suture-related complications after congenital cataract surgery: Vicryl versus Mersilene sutures

Purpose: To evaluate 10-0 polyester sutures (Mersilene) and 10-0 absorbable polyglactin sutures (Vicryl) for small-incision congenital cataract surgery. Setting: Goldschleger Eye Institute, Sheba Medical Center, Tel-Aviv University, Tel-Aviv, Israel. Methods: A retrospective review comprised 51 patients (70 eyes) who had small-incision congenital cataract extraction and intraocular lens implantation between 1999 and 2005. Surgery was done using Mersilene sutures or Vicryl sutures. Retinoscopy and a careful examination for suture-related complications were done 1 week after surgery and then every month for 6 months. The sutures were removed in cases of local tissue reaction but not for high postoperative astigmatism. The t test was used to evaluate postoperative astigmatism and the Fisher exact test, to evaluate the difference in the incidence of suture-related complications. Results: The patients' age ranged from 2 months to 15 years. Ten cases (18%) of corneal vascularization occurred in the Mersilene group during the 6-month follow-up period. This necessitated suture removal, after which 1 incident of endophthalmitis occurred. In contrast, no suture-related complications were noted in the Vicryl group during that time. The difference in the incidence of complications between the 2 groups approached statistical significance (P = .07). Mean astigmatism 1 week postoperatively was 2.3 diopters (D) ± 2.1 (SD) in the Mersilene group, which was significantly higher than in the Vicryl group (mean 1.4 ± 1.1 D) (P = .038). However, the mean astigmatism decreased to less than 1.0 D in both groups during the 6-month follow-up period. Conclusion: Vicryl sutures are recommended for small-incision congenital cataract surgery.