INDUCED ASTIGMATISM FOR EXTRACAPSULAR CAT ARACT-EXTRACTION WITH NO-STITCH-TECHNIQUE AND MODIFIED WOUND CLOSURES

Background For planned extracapsular cataract extraction the no-stitch technique with 11-mm tunnel width has been well established. Four mod ifications of wound dosure were performed to further reduce surgically induced astigmatism. Patients and Methods In this prospective study w e controlled 250 eyes of 250 consecutive patients 4 months after surge ry with four different wound constructions: sutureless wound closure ( n = 70), singular perpendicular suture (n = 100), cross suture (n = 40 ) in 12 o'clock position or sutureless wound closure in temporal posit ion (n = 40). Results Surgically 'Induced Astigmatism' was for eyes wi th preoperative 'With the Rule Astigmatism' (vs Against the Rule astig matism), operation in 12 o'clock position and sutureless wound closure 2.22+/-0.77 D (1.66+/-0.94 D), with perpendicular suture 1.66+/-0.93 D (1.24+/-0.82 D), and with cross suture 1.47+/-0.96 D (0.9+/-1.13 D). Temporal incision was only performed in preoperative 'Against-the-Rul e-Astigmatism' eyes and resulted in 0.6 D of 'Induced Astigmatism'. Pr eoperative average astigmatism was 0.86+/-0.68 D (1.01+/-0.95 D). Conc lusions For preoperative 'With the Rule Astigmatism', operation in 12 o'clock position and singular perpendicular suture and for 'Against th e Rule Astigmatism' (especially > 1.5 D) temporal incision is recommen ded.