Deep versus appositional suturing of the scleral pocket incision for astigmatic control in cataract surgery

A study was performed to determine whether alternative suturing techniques of a standard wound play a significant role in the immediate and long-term postoperative course of corneal astigmatism. Two groups of patients had phacoemulsification and posterior chamber lens implantation through a scleral pocket incision closed with a continuous suture. In one group, the sutures were apposed to the posterior edge of the scleral incision; in the second group, deep suture placement designed to incorporate the internal layer of the scleral pocket was used. The deep suture group demonstrated significantly reduced transient iatrogenic astigmatism but the eventual healed astigmatic results were similar for the two groups. The deep suture group developed no filtration blebs; these did occur in three of 50 cases sutured with the appositional technique.