ASTIGMATISM DECAY IMMEDIATELY FOLLOWING SUTURE REMOVAL

In a prospective study of 34 patients with high post-operative astigma tism (mean 6.90 D, range 2.75-15.00 D) following extracapsular catarac t surgery (13 limbal sections and 21 corneal sections), we used kerato metry to assess the changes in corneal curvature seen within 30 minute s of suture removal and compared these with the astigmatism found 2 we eks later, The greatest change occurred within the first 5 minutes of suture removal (mean 3.63 D; 95% confidence interval (95% CI) 2.85-4.4 1), The rate of decay then declined so that between 15 and 30 minutes the mean change was 0.56 D (95% CI 0.43-0.69), At 2 weeks a further me an decay of 1.29 D (95% CI 0.99-1.61) occurred, Of the 6 patients exhi biting a residual astigmatism greater than 3.00 D at 30 minutes, 4 con tinued to do so 2 weeks later, Our study suggests that keratometry 30 minutes following suture removal is only moderately different from tha t seen 2 weeks later, Although not stable enough to suggest that patie nts could be routinely refracted within 30 minutes of suture removal, in cases where early visual recovery is essential, such as in monocula r patients, it may be reasonable to offer a temporary spectacle correc tion immediately following suture removal, Furthermore keratometry at 30 minutes after suture removal accurately predicts the necessity for further removal of sutures and indicates which patients can be dischar ged to the care of their own optometrist, making a further hospital vi sit unnecessary.