Re-inventing the straight incision with a single central suture in manual small-incision cataract surgery to minimize surgically induced astigmatism

Indian J Ophthalmol. 2022 Nov;70(11):3875-3878. doi: 10.4103/ijo.IJO_1533_22.

Abstract

Purpose: To calculate the surgically induced astigmatism (SIA) in MSICS through a superiorly placed straight scleral incision closed with a single, central, perpendicular 10-0 polyamide suture and to document any suture-related complaints and complications.

Methods: A retrospective, hospital-based study was carried out in 50 cases of uncomplicated senile cataract (>50 year) with nuclear sclerosis ≥ grade 4, "with the rule" astigmatism who underwent MSICS through a superior, straight incision with a single, central, perpendicular 10-0 nylon suture. Patients with "against the rule" astigmatism, keratoconus, pre-existing corneal opacity, astigmatism >2D, distorted or oblique mires, and previous ocular surgeries and unwilling to participate were excluded.

Results: The mean age of the patients was 64.81 + 2.824 years, with a male: female ratio of 1.38:1. The mean SIA at day 7, week 6, and 12 weeks was 0.539 + 0.118, 0.529 + 0.134, and 0.524 + 0.129, respectively. Only 6 patients (12%) complained of foreign body sensation. No patient developed any suture-related complications.

Conclusion: SIA is significantly reduced in straight incision by applying a single, central, and perpendicular 10-0 polyamide suture, as compared to a straight incision without a suture.

Keywords: Best corrected visual acuity; manual small-incision cataract surgery; straight incision; surgically induced astigmatism; uncorrected visual acuity.

MeSH terms

  • Aged
  • Astigmatism* / diagnosis
  • Astigmatism* / etiology
  • Astigmatism* / prevention & control
  • Cataract Extraction* / adverse effects
  • Cataract* / complications
  • Cornea / surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nylons
  • Ophthalmology*
  • Phacoemulsification* / adverse effects
  • Retrospective Studies
  • Surgical Wound* / complications
  • Surgical Wound* / surgery
  • Sutures

Substances

  • Nylons