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Int J Med Sci 2024; 21(8):1541-1551. doi:10.7150/ijms.93994 This issue Cite

Research Paper

Application of sutureless corneal incision for patients with congenital ectopia lentis - Is it feasible, effective and safe?

Yang Sun, MD^1,2, Tianhui Chen, MD^1,2, Zexu Chen, MD^1,2, Wannan Jia, MD^1,2, Yan Liu, MD^1,2, Zhennan Zhao, MD, PhD^1,2✉, Yongxiang Jiang, MD, PhD^1,2✉

1. Department of Ophthalmology and Vision Science, Eye and ENT Hospital of Fudan University, Shanghai, China.
2. NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China.

✉ Corresponding authors: Yongxiang Jiang, Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 83 Fenyang Rd, Shanghai, China, 200031 Tel: +86 021 64377134; Fax: +86 021 64377151; E-mail: yongxiang_jiangcom. Zhennan Zhao, Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 83 Fenyang Rd, Shanghai, China, 200031 Tel: +86 021 64377134; Fax: +86 021 64377151; E-mail: atzzn1984com. More

Abstract

Purpose: To compare the clinical outcomes, feasibility, and safety between groups with sutured and sutureless wound closure in congenital ectopia lentis (CEL) patients.

Methods: Patients with CEL who received phacoemulsification combined with intrascleral fixation of capsular hook (CH) and implantation of capsular tension ring (CTR) and in-the-bag intraocular lens (IOL) were included in this study.

Results: A total of 68 eyes of 34 patients aged 18 years or younger were enrolled in this study. Incisions of 21 patients (34 eyes) did not require sutures while sutures were applied in 21 patients (34 eyes). Postoperative uncorrected distance visual acuity, best corrected distance visual acuity and intraocular pressure measurements were comparable on follow-up visits (P > 0.05). The magnitude of surgically induced astigmatism was significantly greater (P = 0.001) in the suture group (Median: 0.47; IQ: 1.63, 2.97) than in the sutureless group (Median: 0.88; IQ: 0.63, 1.35). No cases of endophthalmitis and retinal detachment were found postoperatively in either group, while suture-related complications were observed in the sutured group, including loose suture with discomfort in 5 (14.71%) eyes, loose suture with mucus infiltration in 3 (8.82%) eyes. In total, 22 sutures (64.71%) of 34 eyes required removal.

Conclusions: Sutureless clear corneal incision in CEL patients can achieve satisfactory clinical results comparable to sutured wound closure in terms of the efficacy and safety. Advantages of this approach are the reduced risk of suture-related complications, no need for additional surgery under general anesthesia for suture removal, and less cost.

Keywords: congenital ectopia lentis, sutureless hydroclosure, corneal sutures, clinical outcomes, suture-related complications

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