Kosin Medical Journal (고신대학교 의과대학 학술지)

Kosin University College of Medicine (고신대학교 의과대학)
권호 표지
DOI QR코드

DOI QR Code

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

  • Yoo, Jae Ho (Department of Ophthalmology, College of Medicine, Kosin University) ;
  • Lee, Sang Joon (Department of Ophthalmology, College of Medicine, Kosin University)
  • Received : 2016.08.18
  • Accepted : 2016.12.14
  • Published : 2018.12.31
⟨ Previous Next ⟩

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: $0.79{\pm}0.64$, unsutured group: $0.68{\pm}0.72$, P = 0.145). Corneal astigmatism measured using keratometry in the sutured and unsutured group at postoperative day 3 were $2.27{\pm}2.12D$ versus $0.83{\pm}0.55D$ 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.

Keywords

References

  1. Leaming DV. Practice styles and preferences of ASCRS members-2002 survey. JCRS 2003;29:1412-20.
  2. Al Mahmood AM, Al-Swailem SA, Behrens A. Clear corneal incision in cataract surgery. Middle East Afr J Ophthalmol 2014;21:25-31. https://doi.org/10.4103/0974-9233.124084
  3. Buzard KA, Febbraro JL. Transconjunctival corneoscleral tunnel "blue line" cataract incision. J Cataract Refract Surg 2000;26:242-9. https://doi.org/10.1016/S0886-3350(99)00343-0
  4. Beltrame G, Salvetat ML, Driussi G, Chizzolini M. Effect of incision size and site on corneal endothelial changes in cataract surgery. J Cataract Refract Surg 2002;28:118-25. https://doi.org/10.1016/S0886-3350(01)00983-X
  5. Hurvitz LM. Late clear corneal wound failure after trivial trauma. Journal of cataract and refractive surgery 1999;25:283-4. https://doi.org/10.1016/S0886-3350(99)80140-0
  6. Cooper BA, Holekamp NM, Bohigian G, Thompson PA. Case-control study of endophthalmitis after cataract surgery comparing scleral tunnel and clear corneal wounds. Am J Ophthalmol 2003;136:300-5. https://doi.org/10.1016/S0002-9394(03)00202-2
  7. Nielsen PJ. Prospective evaluation of surgically induced astigmatism and astigmatic keratotomy effects of various self-sealing small incisions. J Cataract Refract Surg 1995;21:43-8. https://doi.org/10.1016/S0886-3350(13)80478-6
  8. Hayashi K, Yoshida M, Hayashi H. Corneal shape changes after 2.0-mm or 3.0-mm clear corneal versus scleral tunnel incision cataract surgery. Ophthalmology 2010;117:1313-23. https://doi.org/10.1016/j.ophtha.2009.11.041
  9. Olsen T, Dam-Johansen M, Bek T, Hjortdal JO. Corneal versus scleral tunnel incision in cataract surgery: a randomized study. J Cataract Refract Surg 1997;23:337-41. https://doi.org/10.1016/S0886-3350(97)80176-9
  10. Huang FC, Tseng SH. Comparison of surgically induced astigmatism after sutureless temporal clear corneal and scleral frown incisions. J Cataract Refract Surg 1998;24:477-81. https://doi.org/10.1016/S0886-3350(98)80287-3
  11. He Y, Zhu S, Chen M, Li D. Comparison of the Keratometric Corneal Astigmatic Power after Phacoemulsification: Clear Temporal Corneal Incision versus Superior Scleral Tunnel Incision. J Ophthalmol 2009;2009:210621.
  12. Mendivil A. Frequency of induced astigmatism following phacoemulsification with suturing versus without suturing. Ophthalmic Surg Lasers 1997;28:377-81.
  13. Dam-Johansen M, Olsen T. Induced astigmatism after 4 and 6 mm scleral tunnel incision. A randomized study. Acta ophthalmol Scandi 1997;75:669-74.
  14. Chen YC, Wu S. Keratometric astigmatism after cataract surgery using small self-sealing scleral incision. Chang Gung Med J 2001;24:19-26.
  15. Gimbel HV, Sun R. Postoperative astigmatism following phacoemulsification with sutured vs. unsutured wounds. Can J Ophthalmol 1993;28:259-62.
  16. Lyle WA, Jin GJ. Prospective evaluation of early visual and refractive effects with small clear corneal incision for cataract surgery. J Cataract Refracti Surg 1996;22:1456-60. https://doi.org/10.1016/S0886-3350(96)80147-7
  17. Kaye SB, Campbell SH, Davey K, Patterson A. A method for assessing the accuracy of surgical technique in the correction of astigmatism. Br J Ophthalmol 1992;76:738-40. https://doi.org/10.1136/bjo.76.12.738
  18. Holladay JT, Cravy TV, Koch DD. Calculating the surgically induced refractive change following ocular surgery. J Cataract Refract Surg 1992;18:429-43. https://doi.org/10.1016/S0886-3350(13)80095-8
  19. McDonnell PJ, Taban M, Sarayba M, Rao B, Zhang J, Schiffman R, et al. Dynamic morphology of clear corneal cataract incisions. Ophthalmology 2003;110:2342-8. https://doi.org/10.1016/S0161-6420(03)00733-4
  20. Taban M, Sarayba MA, Ignacio TS, Behrens A, McDonnell PJ. Ingress of India ink into the anterior chamber through sutureless clear corneal cataract wounds. Arch Ophthalmol 2005;123:643-8. https://doi.org/10.1001/archopht.123.5.643
  21. Colleaux KM, Hamilton WK. Effect of prophylactic antibiotics and incision type on the incidence of endophthalmitis after cataract surgery. Can J Ophthalmol 2000;35:373-8. https://doi.org/10.1016/S0008-4182(00)80124-6
  22. Taban M, Behrens A, Newcomb RL, Nobe MY, Saedi G, Sweet PM, et al. Acute endophthalmitis following cataract surgery: a systematic review of the literature. Arch Ophthalmol 2005;123:613-20. https://doi.org/10.1001/archopht.123.5.613
  23. Lundstrom M, Wejde G, Stenevi U, Thorburn W, Montan P. Endophthalmitis after cataract surgery: a nationwide prospective study evaluating incidence in relation to incision type and location. Ophthalmology 2007;114:866-70. https://doi.org/10.1016/j.ophtha.2006.11.025
  24. Karabulut R, Sonmez K, Turkyilmaz Z, Bagbanci B, Basaklar AC, Kale N. An In Vitro and In Vivo Evaluation of Tensile Strength and Durability of Seven Suture Materials in Various pH and Different Conditions: An Experimental Study in Rats. Indian J Surg 2010;72:386-90. https://doi.org/10.1007/s12262-010-0158-5
  25. Samuelson SW, Koch DD, Kuglen CC. Determination of maximal incision length for true small-incision surgery. Ophthalmic Surg 1991;22:204-7.