Selective argon laser suturelysis versus needle suturelysis to treat induced corneal astigmatism after cataract surgery.

PURPOSE: To compare the complications and subjective experience of patients having argon laser suturelysis (LS) with those of patients having needle suturelysis (NS) for corneal astigmatism after extracapsular cataract extraction (ECCE).

SETTING

Department of Ophthalmology, Tan Tock Seng Hospital, Singapore.

METHODS

This prospective study comprised 30 patients (30 eyes) with more than 3.00 diopters of with-the-rule astigmatism after ECCE. A minimum of 5 weeks after surgery, 2 sutures along the steepest meridian were lysed by the same surgeon, 1 by a needle and the other by laser using a Hoskins lens. Patients were randomized to receive NS first followed by LS or LS followed by NS. The complications were recorded. The patients subjectively graded their fear and discomfort/pain during suturelysis using a scale from 0 to 10. Patient preference for either procedure was also recorded.

RESULTS

The complications of NS were conjunctival epithelial defect (17/30), subconjunctival hemorrhage (13/30), and corneal abrasion (4/30) and of LS, minor conjunctival burn (1/30) and conjunctival epithelial defect (1/30). The mean subjective fear and discomfort/pain scores in the NS group were significantly higher than in the LS group (P =.0010 and P =.0014, respectively). Nineteen patients preferred LS, 3 preferred NS, and 8 had no preference for either procedure.

CONCLUSION

Argon laser suturelysis was associated with fewer complications than NS and was preferred by patients.