Prospective, randomized vector analysis of astigmatism after three-, one-, and no-suture phacoemulsification

D. T. Azar, W. J. Stark, J. Dodick, J. M. Khoury, S. Vitale, C. Enger, C. Reed

Research output: Contribution to journalArticle

Abstract

Purpose: To compare surgically induced astigmatism and visual outcomes after three-, one-, and no-suture phacoemulsification. Setting: Johns Hopkins Hospital, Baltimore, Maryland, and Manhattan Eye, Ear, and Throat Hospital, New York, New York, USA. Methods: This prospective, randomized study followed 131 patients treated with phacoemulsification with a 5.5 mm self-sealing scleral tunnel and implantation of a 5.5 mm poly(methyl methacrylate) posterior chamber lens. Radial 10-0 nylon sutures were used in the three- and one-suture groups. Results: Mean astigmatism was greatest in the first postoperative week in all groups and stabilized after 8 weeks. The percentage of patients with-the-rule (WTR) astigmatism increased from baseline in the one- and three-suture groups and decreased in the sutureless group. Mean uncorrected Snellen acuity was significantly better in the no- and one- suture groups than in the three-suture group at 1 week. There were no significant differences in uncorrected acuity at other times. No statistically significant differences in the surgically induced spherical equivalent were noted among the three groups during the 1 year follow-up. There was significantly less surgically induced keratometric astigmatism in the one-suture group at 4 (P = .03) and 8 (P = .007) weeks postoperatively. At all follow-ups, the sutureless group had the greatest proportion of patients with significant ATR astigmatic shift (1 week, 17%; 4 weeks, 32%), and the lowest proportion of patients with significant WTR astigmatic shift (10% after 1 week). At 4 weeks, the percentage of patients with significant WTR shift in the one-suture group dropped to that in the sutureless group (10%); however, those in the one-suture group had less ATR astigmatic shift (16%). Conclusion: Sutureless and one-suture surgery resulted in a low percentage of WTR induced astigmatism 4 weeks postoperatively. Compared with sutureless surgery, the one-suture surgery resulted in less ATR shift.

Original languageEnglish (US)
Pages (from-to)1164-1173
Number of pages10
JournalJournal of Cataract and Refractive Surgery
Volume23
Issue number8
StatePublished - 1997
Externally publishedYes

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Phacoemulsification
Astigmatism
Sutures
Baltimore
Nylons
Polymethyl Methacrylate
Pharynx
Lenses
Ear

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Azar, D. T., Stark, W. J., Dodick, J., Khoury, J. M., Vitale, S., Enger, C., & Reed, C. (1997). Prospective, randomized vector analysis of astigmatism after three-, one-, and no-suture phacoemulsification. Journal of Cataract and Refractive Surgery, 23(8), 1164-1173.

Prospective, randomized vector analysis of astigmatism after three-, one-, and no-suture phacoemulsification. / Azar, D. T.; Stark, W. J.; Dodick, J.; Khoury, J. M.; Vitale, S.; Enger, C.; Reed, C.

In: Journal of Cataract and Refractive Surgery, Vol. 23, No. 8, 1997, p. 1164-1173.

Research output: Contribution to journalArticle

Azar, DT, Stark, WJ, Dodick, J, Khoury, JM, Vitale, S, Enger, C & Reed, C 1997, 'Prospective, randomized vector analysis of astigmatism after three-, one-, and no-suture phacoemulsification', Journal of Cataract and Refractive Surgery, vol. 23, no. 8, pp. 1164-1173.
Azar, D. T. ; Stark, W. J. ; Dodick, J. ; Khoury, J. M. ; Vitale, S. ; Enger, C. ; Reed, C. / Prospective, randomized vector analysis of astigmatism after three-, one-, and no-suture phacoemulsification. In: Journal of Cataract and Refractive Surgery. 1997 ; Vol. 23, No. 8. pp. 1164-1173.
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abstract = "Purpose: To compare surgically induced astigmatism and visual outcomes after three-, one-, and no-suture phacoemulsification. Setting: Johns Hopkins Hospital, Baltimore, Maryland, and Manhattan Eye, Ear, and Throat Hospital, New York, New York, USA. Methods: This prospective, randomized study followed 131 patients treated with phacoemulsification with a 5.5 mm self-sealing scleral tunnel and implantation of a 5.5 mm poly(methyl methacrylate) posterior chamber lens. Radial 10-0 nylon sutures were used in the three- and one-suture groups. Results: Mean astigmatism was greatest in the first postoperative week in all groups and stabilized after 8 weeks. The percentage of patients with-the-rule (WTR) astigmatism increased from baseline in the one- and three-suture groups and decreased in the sutureless group. Mean uncorrected Snellen acuity was significantly better in the no- and one- suture groups than in the three-suture group at 1 week. There were no significant differences in uncorrected acuity at other times. No statistically significant differences in the surgically induced spherical equivalent were noted among the three groups during the 1 year follow-up. There was significantly less surgically induced keratometric astigmatism in the one-suture group at 4 (P = .03) and 8 (P = .007) weeks postoperatively. At all follow-ups, the sutureless group had the greatest proportion of patients with significant ATR astigmatic shift (1 week, 17{\%}; 4 weeks, 32{\%}), and the lowest proportion of patients with significant WTR astigmatic shift (10{\%} after 1 week). At 4 weeks, the percentage of patients with significant WTR shift in the one-suture group dropped to that in the sutureless group (10{\%}); however, those in the one-suture group had less ATR astigmatic shift (16{\%}). Conclusion: Sutureless and one-suture surgery resulted in a low percentage of WTR induced astigmatism 4 weeks postoperatively. Compared with sutureless surgery, the one-suture surgery resulted in less ATR shift.",
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T1 - Prospective, randomized vector analysis of astigmatism after three-, one-, and no-suture phacoemulsification

AU - Azar, D. T.

AU - Stark, W. J.

AU - Dodick, J.

AU - Khoury, J. M.

AU - Vitale, S.

AU - Enger, C.

AU - Reed, C.

PY - 1997

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N2 - Purpose: To compare surgically induced astigmatism and visual outcomes after three-, one-, and no-suture phacoemulsification. Setting: Johns Hopkins Hospital, Baltimore, Maryland, and Manhattan Eye, Ear, and Throat Hospital, New York, New York, USA. Methods: This prospective, randomized study followed 131 patients treated with phacoemulsification with a 5.5 mm self-sealing scleral tunnel and implantation of a 5.5 mm poly(methyl methacrylate) posterior chamber lens. Radial 10-0 nylon sutures were used in the three- and one-suture groups. Results: Mean astigmatism was greatest in the first postoperative week in all groups and stabilized after 8 weeks. The percentage of patients with-the-rule (WTR) astigmatism increased from baseline in the one- and three-suture groups and decreased in the sutureless group. Mean uncorrected Snellen acuity was significantly better in the no- and one- suture groups than in the three-suture group at 1 week. There were no significant differences in uncorrected acuity at other times. No statistically significant differences in the surgically induced spherical equivalent were noted among the three groups during the 1 year follow-up. There was significantly less surgically induced keratometric astigmatism in the one-suture group at 4 (P = .03) and 8 (P = .007) weeks postoperatively. At all follow-ups, the sutureless group had the greatest proportion of patients with significant ATR astigmatic shift (1 week, 17%; 4 weeks, 32%), and the lowest proportion of patients with significant WTR astigmatic shift (10% after 1 week). At 4 weeks, the percentage of patients with significant WTR shift in the one-suture group dropped to that in the sutureless group (10%); however, those in the one-suture group had less ATR astigmatic shift (16%). Conclusion: Sutureless and one-suture surgery resulted in a low percentage of WTR induced astigmatism 4 weeks postoperatively. Compared with sutureless surgery, the one-suture surgery resulted in less ATR shift.

AB - Purpose: To compare surgically induced astigmatism and visual outcomes after three-, one-, and no-suture phacoemulsification. Setting: Johns Hopkins Hospital, Baltimore, Maryland, and Manhattan Eye, Ear, and Throat Hospital, New York, New York, USA. Methods: This prospective, randomized study followed 131 patients treated with phacoemulsification with a 5.5 mm self-sealing scleral tunnel and implantation of a 5.5 mm poly(methyl methacrylate) posterior chamber lens. Radial 10-0 nylon sutures were used in the three- and one-suture groups. Results: Mean astigmatism was greatest in the first postoperative week in all groups and stabilized after 8 weeks. The percentage of patients with-the-rule (WTR) astigmatism increased from baseline in the one- and three-suture groups and decreased in the sutureless group. Mean uncorrected Snellen acuity was significantly better in the no- and one- suture groups than in the three-suture group at 1 week. There were no significant differences in uncorrected acuity at other times. No statistically significant differences in the surgically induced spherical equivalent were noted among the three groups during the 1 year follow-up. There was significantly less surgically induced keratometric astigmatism in the one-suture group at 4 (P = .03) and 8 (P = .007) weeks postoperatively. At all follow-ups, the sutureless group had the greatest proportion of patients with significant ATR astigmatic shift (1 week, 17%; 4 weeks, 32%), and the lowest proportion of patients with significant WTR astigmatic shift (10% after 1 week). At 4 weeks, the percentage of patients with significant WTR shift in the one-suture group dropped to that in the sutureless group (10%); however, those in the one-suture group had less ATR astigmatic shift (16%). Conclusion: Sutureless and one-suture surgery resulted in a low percentage of WTR induced astigmatism 4 weeks postoperatively. Compared with sutureless surgery, the one-suture surgery resulted in less ATR shift.

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