Ophthalmic Surgery and
Lasers
Volume 26 (6) * November/December 1995 * Brief Report
(abstract)
Effects of Wound Architecture and Suture Technique on Postoperative
Astigmatism
Howard V. Gimbel, MD
Ran Sun, MD
Brian M. DeBroff, MD
BACKGROUND AND OBJECTIVE
- A prospective randomized investigation was performed to
evaluate the effects of wound architecture and suture techniques on
postoperative astigmatism after phacoemulsification and intraocular lens
implantation.
PATIENTS AND METHODS
- Two hundred eyes with preexisting with-the-rule astigmatism
were randomized into four groups: (1) sutureless scleral tunnel frown incision,
(2) scleral tunnel frown incision with a horizontal suture, (3) scleral tunnel
frown incision with both a horizontal and a running suture, and (4) posterior
limbal acute beveled cataract incision with a running suture. All the incisions
were placed in the vertical steep meridian.
RESULTS
- Data were analyzed from 128 cases with 1-year follow-up. The
results revealed that at the 2-month postoperative visit, preexisting
astigmatism was significantly reduced in group 1 (P = .029) and
significantly increased in groups 3 (P = .020) and 4 (P
= .005). There was no significant change in group 2 (P = .06). By
the 1-year postoperative visit, there was no significant difference in
astigmatism from preoperative levels for all four groups. Vector analysis
revealed no significant difference in the mean surgically induced cylinder at 1
year in all four groups. The number of eyes with induced against-the-rule
astigmatism, however, was significantly higher than the number of eyes with
induced with-the-rule astigmatism in all four groups (P < .01).
CONCLUSION
- The authors found that sutured wounds placed in the vertical
steep meridian may initially increase with-the-rule astigmatism, whereas
nonsutured wounds placed in the vertical steep meridian may initially reduce
with-the-rule astigmatism. By 1 year, however, a mean flattening of the vertical
steep meridian was observed in the three groups with sutures as well as in the
group without sutures. [Ophthalmic Surg Lasers 1995;26:524–528.]
- From the Gimbel Eye Centre, Calgary, Alberta, Canada.
- Accepted for publication March 3, 1995.
- Presented in part at the Association for Research in Vision and
Ophthalmology Annual Meeting, May 5, 1994, Sarasota, FL.
- Request reprints from Howard V. Gimbel, MD, Gimbel Eye Centre, #450, 4935
40 Avenue NW, Calgary, Alberta, Canada T3A 2N1.
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