Changes in corneal curvature induced by sutures and incisions.

To clarify the mechanisms by which incisions and sutures produce corneal astigmatism, we made incisions and wedge resections closed by sutures in the corneoscleral limbus of human eye bank eyes, studying the changes in corneal curvature by shadowgraph photography of the corneal contour, by central keratometry, and by measurement of corneal diameter. The compression of tissue within the sutures or the closure of an excision of a wedge of tissue by sutures induced astigmatism in the meridian of surgery regardless of changes in the sagittal depth of the anterior chamber. Sutures and wedge resections closed by sutures in the anterior part of the cornea compressed or removed more tissue from the anterior part than the posterior part, producing a depression of the limbal cornea toward the anterior chamber and steepening the central cornea in the meridian of surgery. The corneal diameter decreased in that meridian. In the opposite meridian, the cornea flattened, the corneal diameter increased, and the sagittal depth decreased.