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Cataract surgery on post radial keratotomy patients

Poster Details


First Author: L.Inferrera ITALY

Co Author(s): A. Meduri   L. Inferrera   G. Tumminello   G. Oliverio   M. Rechichi   P. Aragona     

Abstract Details

Purpose:

This study aims to evaluate and to compare three different approaches of cataract surgery to patients with previous radial keratotomy (RK), and to analyze the mechanical properties of the cornea after cataract surgery. The stabilizing suture of the RK incision works safer, with a lower risk of dehiscences and less postoperative astigmatism.

Setting:

Department of Surgical Specialties, Ophthalmology Clinic, University of Messina, Messina 98100, Italy. Department of Ophthalmology, University Magna Graecia, Catanzaro 88100, Italy. Mazzotta Cross-Linking & Refractive Surgery Center, Siena 53100, Italy. Department of Ophthalmology, State University of New York- Downstate, Brooklyn and Manhattan, New York 11203, United States

Methods:

In our study eighteen patient with history of 16 cuts radial keratotomy were examined and divided into three groups, giving a total of 24 eyes. All phacoemulsifications were performed using the “stop and chop” technique with a Sovereign-Abbott Medical Optic or Infinity-Alcon device. Phacoemulsification was performed in the first group with a superior entrance main incision, using a 2.75 mm keratome blade. The second group underwent phacoemulsification with a temporal entrance main incision, instead the third group had a temporal main incision plus a 10-0 nylon stabilizing suture, placed before surgery

Results:

In the first group intraoperative dehiscence occurred in three eyes (37.5%), without aqueous leakage from the anterior chamber, and required immediate application of a suture to maintain corneal stability. The mean residual astigmatism was +1.25±0.46 diopters. The best corrected visual acuity (BCVA), exceeding 0.3 logMAR, was not achieved in two patients, and 0.2 logMAR in the third patient. In the second group dehiscence occurred in two radial scars (20%) and the mean residual astigmatism was +1.09±0.44 diopter. The BCVA was respectively 0.2 logMAR, and 0.1 logMAR. In the third group, no intraoperative dehiscences were observed, with an average astigmatism of +0.75±0.29 diopters.

Conclusions:

This procedure significantly reduced the risk of dehiscence of RK scars during phacoemulsification (P<0.05), preserving the intact corneal anatomy and offering a better visual prognosis.So with our stabilizing suture makes it possible to work safer, with a lower risk of dehiscences and less postoperative astigmatism.

Financial Disclosure:

None

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