The removal of 10/0 polyester (Mersilene) sutures after small incision congenital cataract surgery.

PURPOSE: To evaluate the use of 10/0 polyester (Mersilene) sutures for closure of small corneal incision after congenital cataract surgery. METHODS: The authors retrospectively reviewed the medical records of 58 cases (42 patients) who underwent congenital cataract extraction and intraocular lens implantation between 1999 and 2004, using Mersilene sutures. An examination looking for suture-related complications and retinoscopy was done 1 week after surgery and then every month for 6 months. The sutures were removed in cases of local tissue reaction, but not due to high postoperative astigmatism. Paired t-test was used to compare patients' age and astigmatism level in those cases who had suture removal (Group 1) as opposed to those who did not (Group 2). RESULTS: In 10 cases (17%) corneal vascularization, necessitating suture removal, was found during 6-month follow-up period, without the trigger of loose suture. Patient age was 3.5+/-3.3 years and 4.4+/3.3 years in Groups 1 and 2, respectively. At 1 week postoperatively the astigmatism value was 1.7+/-1.7 diopter (D) and 2.3+/-2.2 D in Groups 1 and 2, respectively, and it reduced to 0.9+/-0.8 in both groups at 6 months postoperatively. One case of endophthalmitis was encountered 2 days after suture removal. CONCLUSIONS: Removal of Mersilene sutures after congenital cataract surgery is required in cases of corneal vascularization, occurring during the first months postoperatively. Owing to the risk of general anesthesia and infection, suture removal should be considered with caution in cases of postoperative astigmatism.

Astigmatism outcomes of scleral tunnel and clear corneal incisions for congenital cataract surgery.

PURPOSE: To evaluate astigmatism outcomes after congenital cataract surgery with intraocular lens implantation using clear corneal or scleral tunnel incisions. METHODS: We retrospectively reviewed the medical records of 46 children (67 eyes), aged 2 months to 12 years, who had undergone nontraumatic cataract extraction and intraocular lens implantation between 1996 and 2001, using a scleral tunnel incision (group 1), or a clear corneal incision (group 2). Refractive astigmatism was measured at 1 week, 3 months, and 5 months after surgery. Paired t-test was used to compare those variables, and Spearman's correlation was used to determine their relation to patient's age. RESULTS: Mean+/-SD astigmatism at 1 week postoperatively was 3.1+/-2.8 Diopter (D) and 2.1+/-1.7 D in groups 1 and 2, respectively. It significantly reduced to 1.1+/-1.2 D and 0.9+/-1.0 D, respectively, in the two groups at 5 months postoperatively (P<0.007). In both groups patients' age was significantly correlated with 1-week postoperative astigmatism (group 1: r=0.64; P=0.001; group 2: r=-0.58; P=0.003), and with the change in cylinder magnitude between 1 week and 3 months postoperatively (group 1: r=-0.67; P=0.001; group 2: r=0.50; P=0.013). CONCLUSION: Children who underwent congenital cataract surgery using clear corneal or scleral tunnel incisions showed high postoperative astigmatism at 1 week postoperatively, which spontaneously reduced during 5 months follow-up. Therefore, suture removal is not necessary in those cases.