Outcomes in Sutured Versus Sutureless Wound Closure in Pediatric Cataract Surgery

Abstract

Purpose: To analyze the postoperative course, specifically postoperative complications, of pediatric patients who underwent cataract surgery by a single surgeon. The type of wound closure was compared to provide an evidence-based approach to surgical technique in pediatric cataract surgery. Methods: This retrospective study analyzed pediatric patients who underwent cataract extraction by a single surgeon from 2014 to 2020. Excluded from the study were patients with postoperative follow-up of less than 1 month. The primary outcome compared postoperative complications between patients with sutured and sutureless wound closure. Other outcomes analyzed included intraocular pressure, mean corrected distance visual acuity, and incidence of procedure needed to remove posterior capsule opacification. Results: The study comprised 116 eyes with sufficient follow-up; 86 had sutureless wound closure and 30 had sutured wound closure. An intraocular lens was placed in 52% of eyes in the sutureless group and in 80% of eyes in the sutured group. There was no statistically significant difference between preoperative and postoperative intraocular pressure between groups. The best corrected distance visual acuity was better in the sutured group at 6 months but not at the most recent follow-up visit. No cases of endophthalmitis were found in either group. There was no statistically significant difference between the incidence of retinal detachments and iris prolapse. Conclusions: The incidence of endophthalmitis, retinal detachment, and iris prolapse was similar between pediatric patients who underwent cataract removal with sutureless versus sutured wound closure. Therefore, it may be reasonable to avoid the suture after pediatric cataract surgery. [ J Pediatr Ophthalmol Strabismus . 2023;60(2):147–151.]

Pediatric cataract surgery: considerations and updates in diagnosis and management

“…The authors note the disadvantage of longer surgical duration and increased astigmatism in the suture group compared to the sutureless group. This prospective study followed two previous retrospective studies with similar conclusions [9,10 ▪ ]. Although preliminary, these studies seem to suggest that suturing the surgical wounds at the end of all pediatric cataract surgeries may be unnecessary particularly in low-risk cases, especially considering the disadvantages of longer anesthesia time, increased astigmatism, and increased amblyopia risk associated with sutures.…”

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

“…No significant differences in visual changes were identified between the sutureless and the sutured groups, being consistent with the study reported by Broyles et al evaluating the visual outcomes in pediatric cataract surgery with or without corneal sutures. 11 This similarity in outcomes could be attributed to advancements in surgical techniques leading to improved clinical outcomes for CEL patients. In our series, both sutureless and sutured wound closure groups exhibited comparable results in terms of visual acuity.…”

“…As previously reported by Broyles et al, patients also displayed greater comfort and reduced inclination to rub the operated eye in the absence of sutures post-surgery. 11 Matalia et al further concluded that loose sutures and vascularization were common factors necessitating suture removal. 30 In our series, 7 sutures were noted as loose that needed removing.…”