Kosin Med J.  2018 Dec;33(3):318-327. 10.7180/kmj.2018.33.3.318.

The effect of suture by absorbable material on corneal astigmatism after phacoemulsification

• Yoo JH
• Lee SJ

• KMID: 2442542
• DOI: http://doi.org/10.7180/kmj.2018.33.3.318

Abstract

OBJECTIVES
To investigate the effect of absorbable suture on surgically-induced corneal astigmatism in 3.0-mm sclera tunnel cataract surgeries.
METHODS
Medical records of patients who underwent phacoemulsification cataract surgery using a 3.0-mm sclera tunnel incision made by a single surgeon were reviewed. Uncorrected distant visual acuity, corneal astigmatism and surgically-induced astigmatism were measured in 56 patients' eyes that underwent sclera tunnel cataract surgery with absorbable sutures (sutured group) and in 23 patients' eyes without sutures (unsutured group). Uncorrected visual acuity, intraocular pressure, slit lamp examination, and automated keratometry were evaluated preoperatively and at 3 days, 2 weeks, 4 weeks, and 8 weeks after cataract operation.
RESULTS
There were no significant differences in preoperative average uncorrected distant visual acuity of the two groups (sutured group: 0.79 ± 0.64, unsutured group: 0.68 ± 0.72, P = 0.145). Corneal astigmatism measured using keratometry in the sutured and unsutured group at postoperative day 3 were 2.27 ± 2.12 D versus 0.83 ± 0.55 D at (P < 0.001), a difference which had disappeared after 4 weeks. Surgically induced astigmatism using the Holladay and Vector methods showed similar outcomes, suggesting that the sutured group exhibited higher astigmatism compared with the unsutured group until 2 weeks post-surgery.
CONCLUSIONS
TPatients undergoing scleral tunnel cataract surgery with absorbable sutures have greater surgically induced astigmatism, especially in the early postoperative period, compared with those without sutures. However, this surgically induced astigmatism due to absorbable sutures in scleral tunnel cataract surgery is temporary and disappears at 4 weeks post-surgery.

Keyword

Cataract surgery; Scleral tunnel incision; Surgically induced astigmatism

MeSH Terms

Astigmatism*
Cataract
Humans
Intraocular Pressure
Medical Records
Phacoemulsification*
Postoperative Period
Sclera
Slit Lamp
Sutures*
Visual Acuity

Figure

• 

  Fig. 1A Changes in uncorrected distant visual acuity. These results showed significant changes over time within the same group. B. Changes of Keratometric astigmatism. Keratometric astigmatism of Group I was significantly different compared with preoperative values until 4 weeks post-surgery. *, ** : significant difference between preoperative corneal astigmatism and specific postoperative period on Student's t-test or Wilcoxon signed rank test (P < 0.05, < 0.01)

• 

  Fig. 2A Surgically induced astigmatism by Vector method. Results of the sutured group showed a decrease in average corneal astigmatism over time. B. Surgically induced astigmatism by Vector method (with the wound astigmatism). Compared to surgically induced astigmatism at 3 days post-surgery, there was a significant decrease at 4 weeks post-surgery. *, ** : significant difference between preoperative corneal astigmatism and specific postoperative period on Student's t-test or Wilcoxon signed rank test (P < 0.05, < 0.01)

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