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ORIGINAL ARTICLE
Year : 2020  |  Volume : 68  |  Issue : 3  |  Page : 460-465

Audit of 1000 consecutive cases of sutureless cataract surgery in children above two years of age


1 Children Eye Care Center, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
2 Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
3 Department of Retina and Uvea, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India

Correspondence Address:
Dr. Pradhnya Sen
Children Eye Care Center, Department of Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Jankikund, Chitrakoot - 485 331, Madhya Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1138_19

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Purpose: To study the safety of sutureless cataract surgery and risk factors for wound leak of clear corneal incision in children affected with congenital or developmental cataract. Methods: It is a retrospective, noncomparative interventional case study involving children in the age group of 2 to 16 years, who underwent cataract surgery with intraocular lens implantation with the minimum follow up of 1 month. Results: Out of 1000 eyes studied, lens matter aspiration with intraocular lens implantation with or without primary posterior capsulorhexis and anterior vitrectomy was done in 609 and 391 eyes, respectively. Incisions of 943 eyes did not require sutures while sutures were applied for wound leak in 57 eyes on the table and in 5 eyes on postoperative day 1. Risk of wound leak for suture application was found to be greater in patients; having age less than 5 years (P < 0.0001), surgeries performed by junior surgeons (P < 0.0003), wound problems (P < 0.0001), intraocular lens (IOL) related factors (P < 0.0001), use of iris hooks (P < 0.0001), and anterior capsulorhexis extension (P < 0.0001). On the first postoperative day, anterior chamber reaction (P < 0.0001) and fibrinous membrane (P = 0.0007) were significantly more in the sutured group. Incidence of postoperative complications was 0.98 per sutured eyes (59 complications in 60 eyes). One patient developed endophthalmitis after suture removal. Conclusion: Sutureless clear corneal incision in pediatric patients undergoing cataract surgery can achieve stable wound. However, after hydro closure, every wound should be checked for water tightness and the leaky wound should be sutured.


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