First Author: N.Samy El Gendy EGYPT
Co Author(s):
Purpose:
To evaluate the role of adding a single interrupted suture to the 5.2mm clear corneal incision, created during PMMA IOL implantation after phacoemulsification, in cases were foldable IOL's were not affordable.
Setting:
: A prospective randomized comparative study.
Methods:
Patients with senile cataract candidate for phacoemulsification cataract extraction with implantation of polymethylmethacrylate (PMMA) intraocular lenses (due to economic reasons), were included. Patients were divided into two groups, in group 1 the 5.2mm clear corneal wound was left sutureless, while in group 2 a single radial 10/0 nylon suture was centered in the middle of the wound. Preoperative and postoperative UCVA, CDVA and astigmatic change was compared in both groups at one month and three months postoperatively.
Results:
Sixty six eyes of 58 patients were included. Age was 58.25+9.8 ranged from 43 to 77 years. Each group included 33 eyes. One month postoperative results: mean UCVA was 0.5 +0.12, group one (range 1.0 to 0.1), while for group 2 UCVA was 0.2+0.16 range (1.0 to 0.2). The difference was statistically significant (p?0.005). The average astigmatic value was 1.69+1.25 DS group 1 and 2.75+-0.75 group 2. The average astigmatic change (postoperative astigmatism – preoperative astigmatism) was 2.25 DS which was statistically higher than group 2 (1.25 (p?0.005). More cases with astigmatism against the rule (ATR) were present in group 1 one month postoperative (5:2 ). Two cases in group 2 had astigmatism of more than -3 DC with axis perpendicular to the suture, had the sutures removed. Three month postoperative results: Mean UCVA was 0.36+0.2 for group one (range 1.0 to 0.3), while for group two UCVA was 0.12+0.16,range (1.0 to 0.6).The difference was statistically significant (p?0.05). All patients were correctable to 6/6 in both groups. The average astigmatism was 2.75+0.93 DC group 1, 2+1.25 DC. The average astigmatic change was 1.34 which was statistically still higher than group 2 (0.50) (p?0.05). Number of cases with ATR astigmatism were still more in group 1 three months postoperative (4:1).
Conclusions:
We recommend the use of a single 10/0 interrupted nylon suture for 5.2mm phacoemulsification clear corneal incisions. Sutures can be selectively removed according to induced astigmatism detected on follow-up visits. ATR induced astigmatism in sutureless incision was difficult to manage.
Financial Disclosure:
None
