Indian Journal of Ophthalmology

ARTICLES
Year
: 1983  |  Volume : 31  |  Issue : 7  |  Page : 978--982

Role of multiple sutures in cataract surgery to control the corneal astigmatism


Kamlesh, Vipin Bihari 
 State Institute of Ophthalmology, Govt MD. Eye Hospital MLN Medical College, Allahabad, India

Correspondence Address:
Kamlesh
State Institute of Ophthalmology, Govt MD. Eye Hospital MLN Medical College, Allahabad
India




How to cite this article:
Kamlesh, Bihari V. Role of multiple sutures in cataract surgery to control the corneal astigmatism.Indian J Ophthalmol 1983;31:978-982


How to cite this URL:
Kamlesh, Bihari V. Role of multiple sutures in cataract surgery to control the corneal astigmatism. Indian J Ophthalmol [serial online] 1983 [cited 2021 Sep 17 ];31:978-982
Available from: https://www.ijo.in/text.asp?1983/31/7/978/29722


Full Text

Aphakic astigmatism is a considerable pro­blem for both surgeons and patients after cataract surgery. A lot of modifications regarding section, suturing, instrumentation, magnification, etc.; have been done from time to time to get the least corneal astigmatism. It has been shown[1],[2],[3], 4 astigmatism can be minimised significantly with the use of multi­ple sutures.

 MATERIAL AND METHODS



With the above theme, 138 senile cataract patients with clear cornea were operated at State Institute of Ophthalmology, Allahabad in the year 1981. After making a limbal based conjuntival flap, the corneoscleral section was made with the help of blade keratome and scissors. After doing sector iridectomy, multiple interrupted sutures of varying num­bers (on, two, three & five) of 8/0 virgin silk were placed with the help of S & T needles The lens was taken out with the help of cryoprobe. Post-operative keratometric observations were done at the end of 1st, 3rd & 6th weeks. Refraction along with glass prescription was done at the end of 6th week.

 OBSERVATIONS



A. Pre-operatively

Total number of = 138 patients

Number of patients = 70 (50.72%) showing astigmatism Average radius of = 7.83 mm lesser curvature

Average radius of = 7.66 mm greater curvature

Maximum astigmatism was seen in a range of 0.25 to 0.75 D.

According to the [Table 3][Table 4][Table 5] the followings results were derived :­

a. When the number of sutures were not taken under consideration :- with suc­cessive follow ups the cases with the rule & bioblique were found to be decreased while that of against the rule increased.

b. When the number of sutures were taken under consideration :- with the increase in number of sutures all types of astig­matism showed an increase at first follow up while a relative increase at the 2nd and 3rd follow-ups was seen in the cases with the rule only.

This fact can be explained on the basis that the use of multiple sutures make the cornea more or less similar to its pre-operative state.

The following results were drawn from [Table 6][Table 7] & Graphs 1 & 2.

a. Number of sutures had inverse relation with the degree of astigmatism. Successive increase in number of multiple sutures decreased the amount of astigmatism significantly.

b. The amout of average astigmatism was reduced more than half from first to third follow up.

c. Surgically produced post-operative had no correlation with the degree of pre­operative astigmatism.

 DISCUSSION & CONCLUSION



Our findings are well in accordance with the view of various workers[1],[2],[3].

The following conclusions have been derived from the above study

a. There is an inverse relation between the number of sutures and amount of astigmatism (when measured both with keratometer & retinoscope). The increase in number of sutures from one onward give abrupt decrease in amount of astigmatism which becomes gradual when the number of sutures is increased to 3 or more than 3. The amount of astigmatism is least with 5 interrupted sutures.

b. Surgically produced post-operative astigmatism has no correlation with the amount of pre-operative astigmatism. There is a tendency of cornea to come at its pre-operatvie state with the use of multiple sutures.

Thus multiple interrupted corneoscleral sutures should be used in cataract surgery to reduce the amount of corneal astigmatism pre-operatively to give the satisfactory visual results in aphakics after prescription of glasses.

References

1Singh and Kumar, 1976, Brit. J. Ophthalmol. 60.
2Taylor D.M., 1959, Amer. J. Ophthalmol. 48; 660.
3Troutman, 1973, Trans. Am. Acad. Ophth. Oto. laryn. 77:563-572.