Corneal Astigmatism After Ecce: A Comparative Study Between Silk Versus Nylon Suture

Abstract

Cataract as a potent cause of loss of vision in old age persons is probably known since the dawn of human civilization. Post operative astigmatism after cataract extraction remains a big problem for cataract surgeons since Jacques Daviel era. Astigmatism is that type of refractive anomaly in which no point focus is formed owing to the unequal refraction of the incident light by the diopteric system of the eye in different meridians. The goal of modern cataract surgery is to produce a pseudophakic with the quality of vision of a normal phakic eye. Various studies to find out any effect of IOL on post operative astigmatism were carried out but results are controversial. MATERIAL AND METHODS: 60 patients suffering from cataract and fit for extraction were enlisted during the month of August 2008 to February 2009. The general, physical and local examination including preoperative Keratometry, vision and tension were recorded. RESULTS: In the present study, male patients were 38 (63%) and female patients were 22 (37%). Out of the total 60 cases studied, corneo-scleral section of 28 cases (47%) were sutured with 10-0 nylon suture (Group A) while sections of 32 cases were sutured with 8-0 black virgin silk suture (Group B).Out of 28 cases of Group A, interrupted sutures were applied in 14 cases (50%) (Group A1). Cross interrupted sutures were applied in 9 cases (32%) Group A2, while bootlace continuous sutures were applied in 5 cases (18%) (Group A3). Out of 32 cases of Group B, interrupted sutures were applied in 26 cases (80%) (Group B1), cross interrupted were applied in 3 cases (10%) (Group B2), while bootlace continuous suture were applied in 3 cases (Group B3). In the present series, 19 cases (31%) showed with the rule astigmatism, 21 cases (36%) showed astigmatism against the rule and 20 cases (33%) showed no astigmatism preoperatively, 16 cases were in the range of 0.50D to 1.0D and 12 cases were in the range of 1.0D to 1.50D. CONCLUSION: To conclude the findings, 10-0 nylon cross interrupted sutures and 8-0 silk cross interrupted sutures are relatively better and causes less degree of postoperative astigmatism in comparison to other suture technique. Decreased postoperative astigmatism can be achieved by posterior limbal incision, small section, limited use of sclera cauterization, proper depth of suture bite and limited use of topical steroids. Type of suture material and suture technique plays a minor role on postoperative astigmatism.