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LETTER TO EDITOR
Year : 2004  |  Volume : 52  |  Issue : 1  |  Page : 87

Suture and surgically induced astigmatism after cataract surgery


Correspondence Address:
Praveen Krishna Ratnagiri


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Source of Support: None, Conflict of Interest: None


PMID: 15132396

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How to cite this article:
Ratnagiri PK. Suture and surgically induced astigmatism after cataract surgery. Indian J Ophthalmol 2004;52:87

How to cite this URL:
Ratnagiri PK. Suture and surgically induced astigmatism after cataract surgery. Indian J Ophthalmol [serial online] 2004 [cited 2019 Dec 12];52:87. Available from: http://www.ijo.in/text.asp?2004/52/1/87/14615

Dear Editor,

I read with great interest the reply letter by Dr.Sood[1] as a response to the comments on her article on keratometric astigmatism after ECCE.[2] I would like to clarify as well as supplement some of the points mentioned.

The cut-off value for against-the-rule (ATR) or with-the-rule (WTR) astigmatism on either side of the vertical (90) or horizontal (180) axis is 20, and not 30 as mentioned by Dr. Sood. Beyond this is oblique astigmatism.[3]

With the greater understanding of corneal topography, terms such as "suture-induced astigmatism" (difference in astigmatism between the pre and postoperative measurements with the sutures still in place) and "surgically induced astigmatism" (difference between the pre and postoperative measurements after all the sutures have been released or removed) are probably more appropriate than ATR and WTR.[3] The authors have tried to analyse the former by two different techniques of suturing.[2] Suture-induced astigmatism arises from suture-tension, tissue oedema, and the underlying surgically induced astigmatism. However, surgically induced astigmatism that results primarily from the incision, its realignment and wound healing, is a better index of the actual amount of astigmatism produced by a surgical procedure. The authors could have analysed this. Interestingly, there is no mention of any suture release for postoperative astigmatism for any of the cases in Dr. Sood's series.[2] The post-suture release keratometric value could have been utilised to calculate the surgically induced astigmatism.



 
  References Top

1.
Sood A. Astigmatism after ECCE in Eastern Nepal. Continuous versus interrupted sutures (Letter in reply). Indian J Ophthalmol 2003;51:284-85.  Back to cited text no. 1
    
2.
Sood A, Thakur SKD, Kumar S, Badhu B. Keratometric astigmatism after ECCE in eastern Nepal. Continuous versus interrupted sutures. Indian J Ophthalmol 2003;51:53-57.  Back to cited text no. 2
    
3.
Swinger CA. Postoperative astigmatism. Surv Ophthalmol 1987;31:219-48.  Back to cited text no. 3
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