Granny knot for interrupted 10-0 nylon sutures in cataract sections.

A granny knot instead of a reef (square) knot is advocated for 10-0 nylon interrupted sutures in limbal cataract sections, especially under a conjunctival flap. The second of the two throws is looped in the direction opposite to that in a reef knot so that the free ends lie at right angles to the plane of the suture. The second throw is used to "run down" the first to tighten the suture. To avoid postoperative erosion through conjunctiva, the ends are cut long with a blade while they lie flush with the sclera. The knot is locked when the traction required to tighten the suture is released and the thinned nylon recovers its original diameter on each side of the knot.