Videokeratography: a comparison between 6 mm sutured and unsutured incisions for phacoemulsification

One of the main aims of small incisions in cataract surgery is to reduce surgically induced astigmatism to a minimum. A prospective study was set up to compare sutured with unsutured 6 mm scleral pocket frown incision wounds for phacoemulsification. Videokeratography was used to study the topographical changes induced by surgery. Two groups of 15 patients were allocated to have either sutured or unsutured 6 mm frown incisions for their phacoemulsification. Videokeratography was performed 1 day pre-operatively, and repeated 6 weeks post-operatively. Statistical analysis of the resultant data is discussed. The results show a modest flattening in the vertical meridian in both groups of patients which was slightly larger in the unsutured group. The astigmatic change did not differ significantly between the two groups. The 6 mm scleral pocket incisions induce a small amount of astigmatism whether sutured or unsutured. However, we felt it was perhaps safer to suture an incision of that size. Videokeratography is an invaluable tool for collection of outcome audit data, and allows for accurate graphical assessment of the effect of differing surgical approaches.