3 AND 1 2 YEARS OF EXPERIENCE WITH EXTRAC APSULAR CATARACT-EXTRACTIONWITH THE NO-STITCH TECHNIQUE/

Since January 1992 planned extracapsular cataract extraction (ECCE) is performed routinely with the no-stitch technique at our clinic. To mi nimize surgically induced astigmatism further, modified wound construc tions for planned ECCE with on 11-mm tunnel width were evaluated. The follow-up time was up to 3 years postoperatively. For 250 eyes wound c losure was performed prospectively either sutureless (n = 70), with a single perpendicular suture (n = 100) or cross sutures (n = 40) at the 12 o'clock position or sutureless in the temporal position (n = 40). The complication rate was 4% (filtering bleb, iris prolapse or transie nt hypotonia). There were no wound ruptures, but once endophthalmitis was observed. Late mean astigmatism after up to 3 years follow-up for vertical incision was 2.05 +/- 1.16 D (1.01 +/- 0.96 D preoperatively) for sutureless wound closure, 1.63 +/- 1.08 D (0.86 +/- 0.95 D) for p erpendicular and 1.76 +/- 0.88 D (0.73 +/- 0.55 D) for cross-sutures. A temporal incision resulted in 0.78 +/- 0.52 D (1.0 +/- 0.69 D) of as tigmatism and was only performed on eyes with against the rule astigma tism preoperatively. Surgically induced astigmatism was stabilized ear ly. For with the rule astigmatism preoperatively, a 12 o'clock incisio n with a perpendicular single suture is recommended and for against th e rule astigmatism, a temporal incision.