Corneal topographic changes after sequential suture removal in a corneal wound burn after phacoemulsification

Abstract

Three sutures placed in a 2.8 mm clear corneal incision after wound burn in phacoemulsification, and their sequential removal at 1 month, the resultant corneal topographic changes, and refraction documented immediately have not been reported, making this case report unique. This case describes the timing of suture removal and stabilization of refraction in a case of corneal wound burn associated with phacoemulsification. A 70-year-old woman presented with diminution of visio in both eyes for 1 year. O/E lens opacification classification system grade NC4C3P2 cataract was present in both eyes with normal fundus. Primary diagnosis was cataract in both eyes. The left eye was planned for microincision cataract surgery by a trainee under local anesthesia. Corneal wound burn and iris chaffing were noted at the end of surgery, and 3 sutures were placed at the main port. At 15 days and 1 month postoperatively, the uncorrected distance visual acuity (UDVA) was 20/80 with high regular astigmatism showing over cylinder on autorefractometer. Sequential suture removal was done 1 month postoperatively with an interval of 15 minutes between each suture and corneal topography performed after each suture removal. Topography exhibited reduction in astigmatism from 10.6 to 1.2 diopters after suture removal. The UDVA and corrected distance visual acuity after 1-hour postsuture removal was 20/32 and 20/20, respectively, with a refraction of −0.50 diopter sphere/−0.50 diopter cylinder @ 95 degrees, which was stable even at 1-month and 6-month follow-up. We conclude that suture removal can be planned as early as 4 weeks with refraction and keratometric readings being stable even after 6 months.