POSTOPERATIVE ASTIGMATISM CONTROL BY SELECTIVE SUTURE REMOVAL

Fifty eyes in 50 patients with > 2.5 dioptres (D) of with-the-rule ast igmatism (refraction) following uncomplicated extracapsular cataract e xtraction were recruited for this prospective study. Selected single s utures were removed and both the amount of astigmatic loss and the cha nge in axis were measured at intervals. After removal of the first sut ure-the mean astigmatic loss at 1 week was 2.9 D by keratometry and th e mean change in the axis was 23 degrees (74% occurred within the firs t hour), The astigmatic loss was greater with subsequent suture remova l, Timing of suture removal (before or after 8 weeks) and the amount o f initial post-operative astigmatism (more than or less than 5 D) had a minimal effect on the total astigmatic loss. We suggest selective si ngle suture removal can be performed safely at 5-6 weeks post-operativ ely,vith removal of a second suture, if necessary, in the steepest axi s after 1 hour. The prescription of spectacles should be delayed for 1 week after the final suture has been removed.