Delayed hypotony, shallow anterior chamber, and choroidal detachment in the postoperative cataract eye. A comparative study of closure with 7-0 silk, 9-0 silk, and 9-0 nylon.

To determine the time relationships between hypotony, choroidal detachment, and shallowing of the anterior chamber, an initial 64 eyes closed with 7-0 black silk were studied with applanation tensions, indirect ophthalmoscopy, and slit lamp examinations before surgery and for six weeks after cataract extraction. Applanation tension less than 6 mm Hg was detected in 72% of eyes, choroidal detachment in 44%, and shallowing of the anterior chamber in 28%. Low intraocular pressure was always detected at the same time or before either choroidal detachment or shallow anterior chamber. The peak period when pressure dropped to less than 6 mm Hg was shortly before 12 to 14 day suture removal or the day after. Suture tract leakage appears to be the predominant mechanism triggering this hypotony. Hypotony is prolonged past the leakage period, probably by ciliary body detachment. This 7-0 silk closure group is compared with 53 eyes closed with 9-0 virgin silk and 45 eyes closed with 9-0 nylon. Both of these latter groups showed substantially lower incidences of hypotony, choroidal detachment, and shallowing of the anterior chamber.