Abstract
A prospective, randomised study was carried out in 135 patients to determine whether the time of removal of continuous sutures in the relief of post-operative astigmatism had any effect on subsequent changes in cylinder power or axis. After uncomplicated extracapsular cataract extraction with a corneal section and continuous 10/0 nylon suture, patients with more than 3 dioptres of cylinder were allocated to have their suture removed at 6,9 or 12 weeks post-operatively. Visual and optical outcome were assessed 1 week after suture removal and at 6 months. Although the time of removal did not affect the change in cylindrical power, the subsequent refraction was more stable when the suture was removed at 12 weeks. However, initial against-the-rule astigmatism did not significantly change after suture removal and resulted in an unsatisfactory final prescription. Suture removal should therefore be performed at 12 weeks, glasses should not be prescribed early, and a poor outcome may be anticipated in those initially against-the-rule.
References
Thornton SP . Cataracts and the surgical control of astigmatism. J Cataract Refract Surg 1989;15:11.
Reading VM . Astigmatism following cataract surgery. Br J Ophthalmol 1984;68:97–104.
Iliff CE, Khodadoust A . The control of astigmatism in cataract surgery. Trans Am Ophthalmol Soc 1967;65:160–7.
Torchia RT, McCarthy RW . The cornered incision - a precision cataract wound. Ophthalmic Surg 1983;14:72–4.
Singh D, Kumar K . Keratometric changes after cataract extraction. Br J Ophthalmol 1976;60:638–41.
Rowan PJ . Corneal astigmatism following cataract extraction. Am Ophthalmol 1978;10:231–4.
Stainer GA, Binder PS, Parker WT, et al The natural and modified course of post-cataract astigmatism. Ophthalmic Surg 1982;13:822–7.
Gorn RA . Surgically induced astigmatism and its spontaneous regression. Ophthalmic Surg 1985;16:162–4.
Kronish JW, Forster RK . Control of corneal astigmatism following cataract extraction by selective suture cutting. Arch Ophthalmol 1987;105:1650–5.
Thygesen J, Reersted P, Fledelius H, Corydon L . Corneal astigmatism after cataract surgery. A comparison of corneal and corneoscleral incisions. Acta Ophthalmol 1979;57:243–50.
Gibson Moore J . Incidence of astigmatism after cataract surgery: comparison of continuous and interrupted sutures. Trans Ophthalmol Soc UK. 1977;97:104–5.
Jaffe NS, Clayman HM . The pathophysiology of corneal astigmatism after cataract extraction. Ophthalmology 1975;79:615–30.
Wishart MS, Wishart PK, Gregor ZJ . Corneal astigmatism following cataract extraction. Br J Ophthalmol 1986;70:825–30.
Troutman RC . Control of corneal astigmatism in cataract and corneal surgery. Trans Pacific Coast Otolaryngol Ophthalmol Soc 1970;51:217–31.
Parker WT, Clorfeine GS . Long-term evolution of astigmatism following planned extracapsular cataract extraction. Arch Ophthalmol 1989;107:353–7.
Swinger CA . Post-operative astigmatism. Surg Ophthalmol 1987;31:219–47.
Emery J . Questions and answers: how do you time the cutting of sutures to relieve astigmatism after cataract surgery? Arch Ophthalmol 1989;107:1732.
Waring G . Corneal structure and pathophysiology. In: Lei-bo witz HM, editor. Corneal disorders. Philadelphia: Sau-nders, 1984:1–6.
Danders FC . On the anomalies of accommodation and refraction of the eye. London: New Sydenham Society, 1864:334.
Hyde LL, Maumenee AE . The double shoelace cross-tied suture. In: Emery J, Paton D, editors. Current concepts in cataract surgery; selected proceedings of the Fourth Biennial Cataract Surgical Congress. Philadelphia: Mosby, 1976:62.
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Stanford, M., Fenech, T. & Hunter, P. Timing of removal of sutures in control of post-operative astigmatism. Eye 7, 143–147 (1993). https://doi.org/10.1038/eye.1993.30
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DOI: https://doi.org/10.1038/eye.1993.30
Keywords
- Astigmatism
- Pseudophakia
- Suture removal
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