Krishnamachary M, Basti S
L.V. Prasad Eye Institute, Hyderabad, India.
J Cataract Refract Surg. 1997 Nov;23(9):1380-3. doi: 10.1016/s0886-3350(97)80118-6.
To compare the efficacy of selective suture release (SSR) with all-suture release (ASR) in controlling corneal astigmatism after cataract surgery.
Sight Saver's Cornea Training Centre, L.V. Prasad Eye Institute, Hyderabad, India.
This prospective, randomized study evaluated the effect on astigmatism of two techniques of suture release in 30 patients with more than 3.00 diopters (D) of corneal astigmatism after cataract surgery. All patients had interrupted sutures with well-healed wounds. Fifteen patients had ASR irrespective of the location of the steep meridian. In the other 15, only the suture located in the steep meridian was selectively released. The pattern of decay of astigmatism after suture release was studied using computerized videokeratography.
Mean pretreatment corneal cylinder was 6.30 D +/- 2.72 (SD) in the ASR group and 6.95 +/- 1.67 D in the SSR group. In the ASR group, corneal cylinder dropped to 3.70 +/- 1.15 D immediately after suture release and further decreased to 1.82 +/- 0.66 D at 1 week (P < .001). In the SSR group, astigmatism swung erratically to the adjoining sutures and decreased unpredictably at an average of 1.32 +/- 2.00 D with each suture release.
The ASR technique was more predictable and less cumbersome than the SSR method.
比较选择性缝线松解术（SSR）与全缝线松解术（ASR）在白内障手术后控制角膜散光方面的疗效。
印度海得拉巴市L.V.普拉萨德眼科研究所视觉保护者角膜培训中心。
这项前瞻性随机研究评估了两种缝线松解技术对30例白内障手术后角膜散光超过3.00屈光度（D）患者散光的影响。所有患者均有间断缝线且伤口愈合良好。15例患者接受全缝线松解术，无论陡峭子午线的位置如何。另外15例患者仅选择性松解位于陡峭子午线的缝线。使用电脑化角膜地形图研究缝线松解后散光的衰减模式。
全缝线松解术组术前平均角膜柱镜为6.30 D±2.72（标准差），选择性缝线松解术组为6.95±1.67 D。在全缝线松解术组，缝线松解后角膜柱镜立即降至3.70±1.15 D，1周时进一步降至1.82±0.66 D（P<.001）。在选择性缝线松解术组，散光不规则地转向相邻缝线，每次缝线松解时平均不可预测地降低1.32±2.00 D。
全缝线松解术技术比选择性缝线松解术方法更可预测且操作更简便。
