Comparison Between Nylon and Polyglactin Sutures in Pediatric Cataract Surgery: A Randomized Controlled Clinical Trial

Mathias V Melega, Roberto Dos Reis, Rodrigo Pessoa Cavalcanti Lira, Denise Fornazari de Oliveira, Carlos Eduardo Leite Arieta, Monica Alves, Mathias V Melega, Roberto Dos Reis, Rodrigo Pessoa Cavalcanti Lira, Denise Fornazari de Oliveira, Carlos Eduardo Leite Arieta, Monica Alves

Abstract

Purpose: To compare the performance of nylon sutures to that of polyglactin sutures in pediatric patients undergoing cataract surgery. Setting: University of Campinas (UNICAMP), Campinas, São Paulo, Brazil Design: A prospective, randomized, partially masked, single-site clinical trial. (https://ichgcp.net/clinical-trials-registry/NCT03812640). Methods: A total of 80 eyes from 80 patients who underwent pediatric cataract surgery were randomized into two groups in block sizes of four. Group A consisted of 41 patients whose surgical incisions were sutured with polyglactin 10-0 material. Group B consisted of 39 patients whose surgical incisions were sutured with nylon 10-0 material. The primary outcome was frequency of suture-related complications in each group. Secondary outcomes were the frequency with which suture removal was necessary. Results: The incidence of suture-related complications within 6 months of follow up was 0 out of 41 eyes (0.00%) in the polyglactin group and 17 out of 39 eyes (43.59%) in the nylon control group (p < 0.001). In all of the eyes with suture-related complications, the sutures were promptly removed. The most frequent complications were vascularization near the suture (17.95%) and loose sutures (17.95%). No ocular or systemic study-related adverse events were observed. Conclusions: Polyglactin sutures were found to be safe and effective for pediatric patients undergoing cataract surgery. Their lower rate of complications and reduced likelihood of removal (and the subsequent need for general anesthesia) make their use preferrable to that of nylon sutures. This study represents the first controlled randomized clinical trial to compare nylon sutures to polyglactin sutures in pediatric patients undergoing cataract surgery. Clinical Trial Registration: URL: https://ichgcp.net/clinical-trials-registry/NCT03812640" title="See in ClinicalTrials.gov">NCT03812640.

Keywords: nylon; pediatric cataract; polyglactin; suture; suture-related complications.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2021 Melega, dos Reis, Lira, de Oliveira, Arieta and Alves.

Figures

Figure 1
Figure 1
Comparison Between nylon and polyglactin corneal sutures in pediatric cataract surgery: CONSORT flow diagram.

References

    1. Foster A, Gilbert C, Rahi J. Epidemiology of cataract in childhood: a global perspective. J Cataract Refract Surg [Internet]. (1997) 23:601–4. 10.1016/S0886-3350(97)80040-5
    1. Gilbert CE, Wood M, Waddel K, Foster A. Causes of childhood blindness in east Africa: results in 491 pupils attending 17 schools for the blind in Malawi. Kenya and Uganda. Ophthalmic Epidemiol [Internet]. (1995) 2:77–84. 10.3109/09286589509057086
    1. Haargaard B, Wohlfahrt J, Fledelius HC, Rosenberg T, Melbye M. Incidence and Cumulative Risk of Childhood Cataract in a Cohort of 2.6 Million Danish Children. Invest Ophthalmol Vis Sci [Internet]. (2004) 45:1316–20. 10.1167/iovs.03-0635
    1. WHO | Priority eye diseases [Internet] . WHO. World Health Organization. (2018). Available online at:
    1. Wilson BME. Pediatric Cataracts : Overview Classification (Categorization). (2016). Available online at:
    1. Heaven CJ, Boase DL. Suppurative keratitis with endophthalmitis due to biodegraded full thickness monofilament nylon corneal sutures. Eur J Implant Refract Surg [Internet]. (1993) 5:164–8. 10.1016/S0955-3681(13)80436-4
    1. Lee BJ, Smith SD, Jeng BH. Suture-related corneal infections after clear corneal cataract surgery. J Cataract Refract Surg [Internet]. (2009) 35:939–42. 10.1016/j.jcrs.2008.10.061
    1. Culbert RB, Devenyi RG. Bacterial endophthalmitis after suture removal. J Cataract Refract Surg. (1999) 25:725–7. 10.1016/S0886-3350(99)00020-6
    1. Khurshid GS, Fahy GT. Endophthalmitis secondary to corneal sutures: Series of delayed-onset keratitis requiring intravitreal antibiotics. J Cataract Refract Surg. (2003) 29:1370–2. 10.1016/S0886-3350(03)00404-8
    1. Acheson CF, London L. Ocular Morbidity Due to Monofilament Nylon Corneal Sutures. Eye [Internet]. (1991) 5:106–12. 10.1038/eye.1991.20
    1. Danjoux JP, Reck AC. Corneal sutures: Is Routine Removal Really Necessary? Eye (Lond). 8:339–42. 10.1038/eye.1994.70
    1. Jackson H, Bosanquet R. Should nylon corneal sutures be routinely removed? Br J Ophthalmol. (1991) 75:663–4. 10.1136/bjo.75.11.663
    1. Bainbridge JWB, Teimory M, Kirwan JF, Rostron CK A. prospective controlled study of a 10/0 absorbablepolyglactin suture for corneal incision phacoemulsification. Eye. (1998) 12:399–402. 10.1038/eye.1998.94
    1. Ethicon . Ethicon product catalog. (2014) p. 208–30. Available online at:
    1. Bar-Sela SM, Spierer O, Spierer A. Suture-related complications after congenital cataract surgery: Vicryl versus Mersilene sutures. J Cataract Refract Surg. (2007) 33:301–4. 10.1016/j.jcrs.2006.10.039
    1. Matalia J, Panmand P, Ghalla P. Original article comparative analysis of non-absorbable 10 - 0 nylon sutures with absorbable 10 - 0 Vicryl sutures in pediatric cataract surgery. (2018) 661–4. 10.4103/ijo.IJO_654_17
    1. Thomas FA. Complications following general anesthesia. Curr Res Anesth Analg. (1940) 19:94–6.
    1. Benezra D. The surgical approaches to paediatric cataract. Eur J Implant Refract Surg [Internet]. (1990) 2:241–4. 10.1016/S0955-3681(13)80091-3
    1. Bartholomew RS, Phillips CI, Munton CG. Vicryl (polyglactin 910) in cataract surgery. A controlled trial. Br J Ophthalmol. (1976) 60:536–8. 10.1136/bjo.60.7.536
    1. Sukhija J, Kaur S. Comparison of two methods of wound closure in paediatric cataract surgery. J Clin Exp Ophthalmol. (2018) 9:766. 10.4172/2155-9570.1000766

Source: PubMed

3
Subskrybuj