[Induced astigmatism in extracapsular cataract extraction with tunnel incision and various wound closures].

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.