Timing of corneal stitches removal after extra capsular cataract extraction for control of postoperative astigmatism

Document Type : Original Article

Authors

1 Ophthalmology Department, Dekerness General Hospital, Dakahlia, Egypt.

2 Ophthalmology Department, Faculty of Medicine for Girls, Cairo, Al-Azhar University, Egypt.

Abstract

ABSTRACT
Background: There are challenges in cataract surgery to predict the postoperative results and correct them. The source of variability is the change in the corneal shape which leads to surgically induced astigmatism.
Objective: To determine the most appropriate time for removal of corneal stitches after extracapsular cataract extraction surgery (ECCE) as regards the stability of refractive status of the eye.
Methodology: An interventional, randomized controlled clinical trial was conducted on 20 eyes of 20 patients who had ECCE surgery and sutures removal 8 weeks after surgery (group I) and 20 eyes of 20 patients who had ECCE surgery and sutures removal 12 weeks after surgery (group II). Visual outcome was assessed before and after suture removal by refraction and keratometry.
Results: Mean surgically induced astigmatism (SIA) in group (I) was -5.09±1.46 diopter (D) postoperative and -2.14±0.86D after 1st suture removal and -1.786±0.66D after all suture removal, there is a statistically significant change of power among group (I). Mean SIA in group (II) was -5.26±1.43D postoperative and -3.82±1.78D after 1st suture removal and -2.818±0.73D after all suture removal, there is a statistically significant change of power among group (II). There is statistically significant higher median power among group II than   group I (P=0.001) after 1st suture removal and after full suture removal.
Conclusion: When interrupted 10/0 nylon corneal suture causes a high degree of astigmatism, it is better to be removed at 8 weeks after surgery, not just being as effective in alleviating astigmatism, but safer and more stable in refraction.

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