Double safe suture during cataract surgery on post radial keratotomy patients using clear corneal incisions

Abstract

Purpose

the aim of this study is to find a safer surgical approach in cataract surgery on eyes previously treated with radial keratotomy using clear corneal incisions.

Setting

Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, University of Messina, Messina, Italy.

Design

Prospective study.

Methods

A prospective study was conducted on a group of 20 patients, 21 eyes with 16 RK incisions were evaluated for cataract phacoemulsification. Samples were divided into two groups: Group 1 underwent surgery with pre-operative one corneal stitch along radial keratotomy incisions near the main access site whereas Group 2 underwent modified surgery with two corneal stitches.

Results

After surgery, visual acuity, corneal hysteresis and corneal strength was evaluated. In all cases, an increased visual acuity was observed. Group 1 showed an UCVA of logMAR 0.22 ± 0.14, while group 2 presented a logMAR of 0.1 ± 0.07. Data did not show a statistically significant difference in UCVA after surgery between the two groups (P = 0.133). Instead, a significant difference in corneal hysteresis (CH), respectively with values of 8.65 ± 1.6 mmHg in group 1 and 9.2 ± 1.8 in group 2 (P = 0.031), and a corneal resistance factor (CRF) with values of 7.87 ± 1.4 mmHg in the first group and 8.65 ± 1.6 mmHg in the second one (P = 0.039) was observed.

Conclusions

Double safe suture technique offers better stabilization of corneal structure during surgery in patients preventively treated with 16 incisions RK.

Keywords

phacoemulsification surgery with high-risk ocular conditions surgical instruments / special techniques corneal wound healing

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References

Cowden

Bores

. A clinical investigation of the surgical correction of myopia by the method of Fyodorov. Ophthalmology 1981; 88: 737–741.

Kulkarni

Mataftsi

Sharma

, et al. Horgan S: long-term refractive stability following combined astigmatic keratotomy and phakoemulsification. Int. Ophthalmol 2009; 29: 109–115.

Gupta

Oakeyc

Ahmedb

, et al. Spectacle independence after cataract extraction in post-radial keratotomy patients using hybrid monovision with ReSTOR multifocal and TECNIS monofocal intraocular lenses. Case Rep Ophthalmol 2014; 5: 157–161.

Liu

Chen

, et al. Cataract surgery and intraocular lens power calculation after radial keratotomy: analysis of 8 cases. Nan Fang Yi Ke Da Xue Xue Bao 2015; 35: 1043–1044.

Chhadva

Cabot

Galor

, et al. Long-term outcomes of radial keratotomy, laser in situ keratomileusis, and astigmatic keratotomy performed consecutively over a period of 21 years. Case Rep Ophthalmol Med 2015; 2015: 592495.

Camellin

Savini

Kenneth

, et al. Scheimpflug camera measurement of anterior and posterior corneal curvature in eyes with previous radial keratotomy. J Refractive Surg 2012; 28: 275–279.

Meduri

Urso

Signorino

, et al. Cataract surgery on post radial keratotomy patients. Int J Opthalmol 2017; 10: 1168–1170.

Garcia-Porta

Fernandes

Queiros

, et al. Corneal biomechanical properties in different ocular conditions and new measurement techniques. ISRN Ophthalmol 2014; 2014: 724546.

Chylack

Wolfe

Singer

, et al. The lens opacities classification system III. The longitudinal study of cataract study group. Arch Ophthalmol 1993; 111: 831–836.

10.

Elsheikh

Geraghty

Rama

, et al. Characterization of age-related variation in corneal biomechanical properties. J R Soc Interface 2010; 7: 1475–1485.

11.

Studer

Larrea

Riedwyl

, et al. Biomechanical model of human cornea based on stromal microstructure. J Biomech 2010; 43: 836–842.

12.

Sher

Golben

Bond

, et al. A retrospective review of photorefractive keratectomy to enhance earlier radial keratotomy. Int Ophthalmol Clin 2011; 51: 39–49.

13.

Budak

Friedman

Koch

. Dehiscence of a radial keratotomy incision during clear corneal cataract surgery. J Cataract Refract Surg 1998; 24: 278–280.

14.

Sedaghat

Ostadi-Moghadam

Jabbarvand

, et al. Corneal hysteresis and corneal resistance factor in pellucid marginal degeneration. J Curr Ophthalmol 2018; 30: 42–47.

15.

Strobbe

Cellini

Barbaresi

, et al. Influence of age and gender on corneal biomechanical properties in a healthy Italian population. Cornea 2014; 33: 968–972.

16.

Avetisov

Bubnova

Novikov

, et al. Experimental study on the mechanical strain of corneal collagen. J Biomech 2013; 46: 1648–1654.

17.

Hwang

Park

Kim

. The biomechanical properties of the cornea and anterior segment parameters. BMC Ophthalmol 2013; 13: 49.

18.

Song

Langenbucher

Gatzioufas

, et al. Effect of biometric characteristics on the change of biomechanical properties of the human cornea due to cataract surgery. Biomed Res Int 2014; 2014: 628019.

19.

Avetisov

Bubnova

Antonov

. Clinical and experimental aspects of investigation of biomechanical properties of corneoscleral shell. Vestn Oftalmol 2013; 129: 82–90.

20.

Denoyer

Ricaud

Van Went

, et al. Influence of corneal biomechanical properties on surgically induced astigmatism in cataract surgery. J Cataract Refract Surg 2013; 39: 1204–1210.