Relaxation of postoperative astigmatism after lens implantation through a 6.25 mm scleral wound in children.
OBJECTIVE
To investigate the evolution of postoperative astigmatism in children having cataract extraction with intraocular lens (IOL) implantation through a 6.25 mm superior scleral tunnel wound.


METHODS
A university clinical practice.


METHODS
A retrospective chart review of all pediatric patients having cataract extraction and IOL implantation in the practice of 1 surgeon from 1995 to 2000 was performed. Statistical comparisons were performed using the Student t test for nonpaired data.


RESULTS
Ten eyes of 9 children were included. Six cataracts were due to corneal or corneoscleral lacerations, 3 were idiopathic, and 1 occurred after blunt trauma. Eight eyes could not be refracted preoperatively because of mature cataract. The mean cylindrical correction of all refractions performed 1 to 15 days after surgery (n = 6) was 6.71 diopters (D) +/- 1.63 (SD); of those performed at 16 to 30 days (n = 6), 2.71 +/- 2.09 D; and of those performed at 31 to 45 days (n = 7), 1.93 +/- 1.48 D. The mean spherical equivalent of the final (dispensed) refraction was -0.21 +/- 1.79 D; the mean cylindrical correction of this refraction was 1.13 +/- 0.79 D. The difference between the cylindrical correction of the final prescription and the corneal astigmatism in fellow eyes was not statistically significant (P =.29).


CONCLUSIONS
Relaxation of large amounts of suture-induced astigmatism occurs in children having cataract extraction. Surgeons should not hesitate to secure scleral wounds meticulously in children for fear of a permanent undesirable refractive outcome.
Brown
S M
SM
Department of Ophthalmology and Visual Sciences, Texas Tech University Health Sciences Center, Lubbock, Texas 79430-7217, USA. eyesmb@ttuhsc.edu
Hodges
M R
MR
Corona
J
J
D000293:Adolescent; D001251:Astigmatism / Q000209:etiology*; D002387:Cataract Extraction; D002648:Child; D002675:Child, Preschool; D006801:Humans; D019654:Lens Implantation, Intraocular; D011183:Postoperative Complications; D012029:Refraction, Ocular; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery*; D013536:Suture Techniques / Q000009:adverse effects*; D014792:Visual Acuity; D014945:Wound Healing