Extracapsular cataract extraction with a sutureless incision for dense cataracts

Purpose: To evaluate the use of extracapsular cataract extraction (ECCE) vi a a sutureless incision for dense cataracts. Setting: Nagata Eye Clinic, Nara, japan. Methods: This retrospective study comprised 51 eyes of 45 consecutive patie nts with dense cataracts who had ECCE with a sutureless incision between Ja nuary 1996 and April 1998. A scleral incision from 6.0 to 8.5 mm was made a t 12 o'clock or between 19 and 12 o'clock (oblique incision). Measures of o utcome included postoperative visual acuity, surgically induced astigmatism (polar value method and vector analysis), complications, and changes in co rneal endothelial cell density and morphology. Results: Self-sealing was achieved in 45 eyes (88.2%), but additional sutur es were required in 6 (11.8%). Intraoperative complications included poster ior capsule rupture in 3 eyes (5.9%) and iris prolapse in 2 (3.9%). Corneal flattening against the preoperative steep meridian was observed in the 12 o'clock incision group (0.24 diopter [D] +/- 1.23 [SD]) and in the oblique incision group (0.17 +/- 0.89 D). By vector analysis, the surgically induce d vector was 1.41 +/- 0.72 D in the 12 o'clock incision group and 1.02 +/- 0.66 D in the oblique incision group. After surgery, the mean cell loss was 8.2% +/- 12.5%. There were no significant differences, however, between ot her preoperative and post operative morphometric indexes. Conclusion: This fast, safe, and inexpensive technique may be a viable trea tment for dense cataracts with large, hard nuclei. (C) 1999 ASCRS and ESCRS .