Astigmatism after phacoemulsification with posterior chamber lens implantation: small incision technique with fibrin adhesive for wound closure.

The scleral pocket technique has dramatically changed wound closure after phacoemulsification with implantation of a posterior chamber lens. The use of single-stitch technique and wound closure by fibrin adhesive is now possible. We conducted a comparative study of 385 consecutive patients; 167 received only fibrin glue for wound closure and 218 had the single-stitch procedure. No complications were observed in either group. Surgically induced astigmatism was smaller in the fibrin group (vector analysis: 0.80 diopters [D]) than in the single-stitch group (vector analysis: 0.99 D). Minimal, statistically insignificant different against-the-rule astigmatism developed: single-stitch group: -0.07 D (Cravy), -0.09 D (Naeser); fibrin adhesive group: -0.13 D (Cravy), -0.17 D (Naeser). These results suggest that postoperative against-the-rule astigmatism can be prevented with fibrin glue.