Control of Astigmatism Following Extracapsular Cataract Extraction with Posterior Chamber Lens Implantation by Selective Suture Cutting

Lee, Jin Hak; Hyung, Sung Min

Abstract

We evaluated the ability of selective suture cutting to reduce postoperative astigmatism due to tight corneo-scleral(C-S) suture in 65 eyes undergone posterior chamber lens implantation. Under operating microscope, two-planned beveled C-S incision was made from 10:00 position to 2:00 position. At the end of operation. C-S wound was sutured at 11:20 position and 12:40 position with 8-0 Vicryl(R), 'X'-shaped suture at 10:40 position. 12-o'clock, and 1:20 position with 10-0 nylon. We cut the C-S suture with 26G disposable needle under slit lamp after local anesthetics(Alkaine(R)) instillation. Keratometric and refractive measurements were obtained before and at selective intervals(group A:4-6 weeks, group B:7-9 weeks, Group C:10-12 weeks) after surgery. Our analysis demonstrated the followings: 1. Remained astigmatism below 1.5 Diopter at 4th week after selective suture cutting were 87.5% in group A, 86.5% in group B, 83.8% in group C. 2. complications due to suture cutting were C-S wonnd disruption(cutting at 5th week after surgery), mild anterior chamber reaction(cutting at 8th week after surgery), and aganinst-the-rule astigmatism(average 1.25D iopter, Group A:18.8%, Group B:13.5%, Group C:16.7%). 3. Selective suture cutting at postoperative 7-9th weeks can correct the postoperative astigmatism.