[No-stitch tunnel incision vs. corneoscleral incision. A prospective, randomized study]

An important factor in early visual recovery after cataract surgery is surgically induced astigmatism. In a randomized clinical trial we compared the development of astigmatism and visual acuity after three different types of incision and suture techniques. Sixty-seven patients were randomized into three groups: (a) scleral tunnel incision (5 mm) without suture (no stitch) (n = 23) (b) scleral tunnel incision (5 mm) with suture (single stitch) (n = 23) (c) corneoscleral incision (5 mm) with suture (CS suture) (n = 21). Implants: 5 mm optic size; follow-up period: 6 months. There was no statistically significant difference among the 3 groups concerning age distribution and preoperative astigmatism. Postoperative follow-up at day 1, weeks 1, 2, months 1, 4 and 6 showed astigmatic values ranging from 0.84 to 1.41 D (means values, vector analysis; differences not significant: P > 0.10). The surgically induced astigmatism ranged from 1.13-1.74 D (differences not significant P > 0.16). At all follow-up dates the mean uncorrected distance acuity did not differ significantly among the three groups (P > 0.35). No quantitative statistically significant differences could be detected among the three incision and suture techniques.