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Selective argon laser suturelysis versus needle suturelysis to treat induced corneal astigmatism after cataract
Chee-Chew Yip1, Hung-Ming Lee, Gerard Nah
1Department of Ophthalmology, Tan Tock Seng Hospital, Singapore, Singapore
Purpose:
To compare the complications and subjective experience of patients having argon laser suturelysis (LS) with those of patients having needle suturelysis (NS) for corneal astigmatism after extracapsular cataract extraction (ECCE).
Setting:
Department of Ophthalmology, Tan Tock Seng Hospital, Singapore.
Methods:
This prospective study comprised 30 patients (30 eyes) with more than 3.00 diopters of with-the-rule astigmatism after ECCE. A minimum of 5 weeks after surgery, 2 sutures along the steepest meridian were lysed by the same surgeon, 1 by a needle and the other by laser using a Hoskins lens. Patients were randomized to receive NS first followed by LS or LS followed by NS. The complications were recorded. The patients subjectively graded their fear and discomfort/pain during suturelysis using a scale from 0 to 10. Patient preference for either procedure was also recorded.
Results:
The complications of NS were conjunctival epithelial defect (17/30), subconjunctival hemorrhage (13/30), and corneal abrasion (4/30) and of LS, minor conjunctival burn (1/30) and conjunctival epithelial defect (1/30). The mean subjective fear and discomfort/pain scores in the NS group were significantly higher than in the LS group (P =.0010 and P =.0014, respectively). Nineteen patients preferred LS, 3 preferred NS, and 8 had no preference for either procedure.
Conclusion:
Argon laser suturelysis was associated with fewer complications than NS and was preferred by patients.
