Suturing microscopic wound leaks can avoid myopic shifts

OCULAR SURGERY NEWS U.S. EDITION March 10, 2009

To test the association between wound leaks and myopic shifts with the Crystalens, our center performed a controlled, retrospective study that was presented as a poster at the 2008 American Academy of Ophthalmology meeting. For several months, we had been routinely performing a Seidel test at the end of cataract surgery. Initially our surgeons were surprised to find small wound leaks, not detectable without a Seidel test, in about one-third of patients. Retrospectively, we reviewed 100 charts of Crystalens patients – 50 who had Seidel negative wounds and 50 with small leaks, detectable only with a Seidel test. Neither group had received sutures. Comparing 1-month postoperative refractions to target, we learned that leaking wounds had an average refractive “surprise,” compared with target refraction, 0.54 D more myopic than those that were Seidel negative at the time of surgery.
It is now our standard of practice to suture any Seidel positive Crystalens wounds. Newer, better methods of sealing incisions may allow us to use a technology even better than suture in the future