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[Induced astigmatism in extracapsular cataract extraction with tunnel incision and various wound closures]
H Häberle1, N Anders, D T Pham
1Augenklinik im Virchow-Klinikum Medizinische Fakultät, Humboldt-Universität zu Berlin.
Background:
For planned extracapsular cataract extraction the no-stitch technique with 11-mm tunnel width has been well established. Four modifications of wound closure were performed to further reduce surgically induced astigmatism.
Patients And Methods:
In this prospective study we controlled 250 eyes of 250 consecutive patients 4 months after surgery with four different wound constructions: sutureless wound closure (n = 70), singular perpendicular suture (n = 100), cross suture (n = 40) in 12 o'clock position or sutureless wound closure in temporal position (n = 40).
Results:
Surgically 'Induced Astigmatism' was for eyes with preoperative 'With the Rule Astigmatism' (vs Against the Rule astigmatism), operation in 12 o'clock position and sutureless wound closure 2.22 +/- 0.77 D (1.66 +/- 0.94 D), with perpendicular suture 1.66 +/- 0.93 D (1.24 +/- 0.82 D), and with cross suture 1.47 +/- 0.96 D (0.9 +/- 1.13 D). Temporal incision was only performed in preoperative 'Against-the-Rule-Astigmatism' eyes and resulted in 0.6 D of 'Induced Astigmatism'. Preoperative average astigmatism was 0.86 +/- 0.68 D (1.01 +/- 0.95 D).
Conclusions:
For preoperative 'With the Rule Astigmatism', operation in 12 o'clock position and singular perpendicular suture and for 'Against the Rule Astigmatism' (especially > 1.5 D) temporal incision is recommended.