Extracapsular cataract extraction with a sutureless incision for dense cataracts.
OBJECTIVE
To evaluate the use of extracapsular cataract extraction (ECCE) via a sutureless incision for dense cataracts.


METHODS
Nagata Eye Clinic, Nara, Japan.


METHODS
This retrospective study comprised 51 eyes of 45 consecutive patients with dense cataracts who had ECCE with a sutureless incision between January 1996 and April 1998. A scleral incision from 6.0 to 8.5 mm was made at 12 o'clock or between 9 and 12 o'clock (oblique incision). Measures of outcome included postoperative visual acuity, surgically induced astigmatism (polar value method and vector analysis), complications, and changes in corneal endothelial cell density and morphology.


RESULTS
Self-sealing was achieved in 45 eyes (88.2%), but additional sutures were required in 6 (11.8%). Intraoperative complications included posterior 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 induced 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 other preoperative and postoperative morphometric indexes.


CONCLUSIONS
This fast, safe, and inexpensive technique may be a viable treatment for dense cataracts with large, hard nuclei.
Kimura
H
H
Nagata Eye Clinic, Nara, Japan.
Kuroda
S
S
Mizoguchi
N
N
Terauchi
H
H
Matsumura
M
M
Nagata
M
M
D000368:Aged; D000369:Aged, 80 and over; D001251:Astigmatism / Q000517:prevention & control; D002387:Cataract Extraction / Q000379:methods*; D002452:Cell Count; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D013536:Suture Techniques; D014792:Visual Acuity