TY - JOUR
T1 - Prospective, randomized vector analysis of astigmatism after three-, one-, and no-suture phacoemulsification
AU - Azar, D. T.
AU - Stark, W. J.
AU - Dodick, J.
AU - Khoury, J. M.
AU - Vitale, S.
AU - Enger, C.
AU - Reed, C.
N1 - Funding Information:
Supported by unrestricted grants from IOLAB and Ioptex (Dr. Dodick) and the Margaret Mosher and Sonny Davis Research Funds (Dr. Stark).
PY - 1997
Y1 - 1997
N2 - Purpose: To compare surgically induced astigmatism and visual outcomes after three-, one-, and no-suture phacoemulsification. Setting: Johns Hopkins Hospital, Baltimore, Maryland, and Manhattan Eye, Ear, and Throat Hospital, New York, New York, USA. Methods: This prospective, randomized study followed 131 patients treated with phacoemulsification with a 5.5 mm self-sealing scleral tunnel and implantation of a 5.5 mm poly(methyl methacrylate) posterior chamber lens. Radial 10-0 nylon sutures were used in the three- and one-suture groups. Results: Mean astigmatism was greatest in the first postoperative week in all groups and stabilized after 8 weeks. The percentage of patients with-the-rule (WTR) astigmatism increased from baseline in the one- and three-suture groups and decreased in the sutureless group. Mean uncorrected Snellen acuity was significantly better in the no- and one- suture groups than in the three-suture group at 1 week. There were no significant differences in uncorrected acuity at other times. No statistically significant differences in the surgically induced spherical equivalent were noted among the three groups during the 1 year follow-up. There was significantly less surgically induced keratometric astigmatism in the one-suture group at 4 (P = .03) and 8 (P = .007) weeks postoperatively. At all follow-ups, the sutureless group had the greatest proportion of patients with significant ATR astigmatic shift (1 week, 17%; 4 weeks, 32%), and the lowest proportion of patients with significant WTR astigmatic shift (10% after 1 week). At 4 weeks, the percentage of patients with significant WTR shift in the one-suture group dropped to that in the sutureless group (10%); however, those in the one-suture group had less ATR astigmatic shift (16%). Conclusion: Sutureless and one-suture surgery resulted in a low percentage of WTR induced astigmatism 4 weeks postoperatively. Compared with sutureless surgery, the one-suture surgery resulted in less ATR shift.
AB - Purpose: To compare surgically induced astigmatism and visual outcomes after three-, one-, and no-suture phacoemulsification. Setting: Johns Hopkins Hospital, Baltimore, Maryland, and Manhattan Eye, Ear, and Throat Hospital, New York, New York, USA. Methods: This prospective, randomized study followed 131 patients treated with phacoemulsification with a 5.5 mm self-sealing scleral tunnel and implantation of a 5.5 mm poly(methyl methacrylate) posterior chamber lens. Radial 10-0 nylon sutures were used in the three- and one-suture groups. Results: Mean astigmatism was greatest in the first postoperative week in all groups and stabilized after 8 weeks. The percentage of patients with-the-rule (WTR) astigmatism increased from baseline in the one- and three-suture groups and decreased in the sutureless group. Mean uncorrected Snellen acuity was significantly better in the no- and one- suture groups than in the three-suture group at 1 week. There were no significant differences in uncorrected acuity at other times. No statistically significant differences in the surgically induced spherical equivalent were noted among the three groups during the 1 year follow-up. There was significantly less surgically induced keratometric astigmatism in the one-suture group at 4 (P = .03) and 8 (P = .007) weeks postoperatively. At all follow-ups, the sutureless group had the greatest proportion of patients with significant ATR astigmatic shift (1 week, 17%; 4 weeks, 32%), and the lowest proportion of patients with significant WTR astigmatic shift (10% after 1 week). At 4 weeks, the percentage of patients with significant WTR shift in the one-suture group dropped to that in the sutureless group (10%); however, those in the one-suture group had less ATR astigmatic shift (16%). Conclusion: Sutureless and one-suture surgery resulted in a low percentage of WTR induced astigmatism 4 weeks postoperatively. Compared with sutureless surgery, the one-suture surgery resulted in less ATR shift.
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U2 - 10.1016/S0886-3350(97)80310-0
DO - 10.1016/S0886-3350(97)80310-0
M3 - Article
C2 - 9368159
AN - SCOPUS:0030830928
SN - 0886-3350
VL - 23
SP - 1164
EP - 1173
JO - Journal of cataract and refractive surgery
JF - Journal of cataract and refractive surgery
IS - 8
ER -