Keratometric astigmatism after ECCE in eastern Nepal. Continuous versus interrupted sutures

Area of Science:

• Ophthalmology
• Surgical Techniques
• Biomaterials

Background:

• Cataract surgery, specifically extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation, is a common procedure.
• Wound closure technique is a critical factor influencing postoperative outcomes, including refractive error.
• Keratometric astigmatism, a measure of corneal shape irregularity, can be induced by surgical manipulation and wound healing.

Purpose of the Study:

• To compare the induced keratometric astigmatism between continuous and interrupted suture techniques for wound closure.
• To evaluate the impact of different suture methods on refractive outcomes following ECCE with IOL implantation.

Main Methods:

• A comparative study involving 60 eyes of 60 patients undergoing conventional ECCE with IOL implantation.
• Patients were divided into two groups: 30 eyes closed with continuous sutures (Group 1) and 30 eyes with interrupted sutures (Group 2).
• Keratometric astigmatism was measured and analyzed using the unpaired student's t-test at 6 weeks postoperatively.

Main Results:

• Continuous sutures (Group 1) induced significantly higher mean keratometric astigmatism (3.53 ± 2.19D) compared to interrupted sutures (Group 2) (1.7 ± 1.35D) at 6 weeks.
• A majority of patients in both groups exhibited with-the-rule astigmatism throughout the study period.
• The difference in induced astigmatism between the two groups was statistically significant.

Conclusions:

• Interrupted sutures are associated with less induced keratometric astigmatism following ECCE with IOL implantation compared to continuous sutures.
• The factors contributing to the higher astigmatism observed with continuous sutures warrant further investigation.
• This finding suggests that interrupted sutures may be preferable for minimizing postoperative astigmatism in this surgical context.