Astigmatism in relation to length and site of corneal lacerations
Keywords:Corneal Lacerations, Corneal Diameter, Astigmatism, Length and Site of corneal lacerations
Background: Corneal lacerations are the common cause of astigmatism that can prevent a good visual outcome. This was to evaluate Astigmatism in relation to the Length and Site of Corneal Lacerations.
Methods: This was a study in the Cornea clinic, Sarojini Devi Eye Hospital and Regional Institute of Ophthalmology, Osmania Medical College, Hyderabad over a period from August 2012 to April 2014. The study group was 25 Patients of corneal lacerations. The data of age and sex, the length of corneal lacerations in terms of corneal diameter of <1/3rd and >1/3rd and the site of the laceration in the cornea either central or peripheral was noted. All the corneal lacerations were sutured with interrupted 10-0 mono filament nylon. Suture removal was done over a period of 6 -12 weeks following surgery. Astigmatism (Diopters) was estimated by Keratometer after sutures removal.
Results: Our study age distribution was 11(44.0%) in >10 -20 yrs, 11 (44.0%) in 21 – 30 yrs and 3(12.0%) in 31 -40 yrs. Sex distribution was 17(68.0%) of males and 8(32.0%) of females. The length of Corneal laceration in terms of corneal diameter was < 1/3rd in 4(16.0%) and >1/3rd in 21(84.0%). The site of Laceration in the cornea was peripheral in 6(24.0%) and central in 19(76.0%). The Astigmatism in relation to Length and Site of Corneal Laceration showed < 2.0 D in 3(12.0%), 2 – 4.0 D in 11(44.0%), 4- 6.0 D in 4(16.0%), > 6.0D in 4(16.0%) and irregular astigmatism in 3(12.0%). The astigmatism in peripheral corneal lacerations of < 1/3rd and > 1/3rd of corneal diameter was < 2.0 D in 12.0% and 2-4.0 D in 12.0% respectively. The Astigmatism in central corneal lacerations of <1/3rd and >1/3rd of corneal diameter was 2- 4.0D in 4.0% and 2-4.0D in 28.0%, 4-6.0D in 16.0%, >6.0D in 16.0% and irregular Astigmatism in 12.0% respectively. Time of sutures removal was 80.0% at 6-8 wks, 12.0% at 8-10 wks and 8.0% at 10 -12 wks.
Conclusions: The corneal astigmatism depends upon the length and site of corneal laceration. Severity of astigmatism was directly proportion to the length of corneal laceration. The wound was nearer to the centre of the cornea, the greater was the astigmatism.
K. Park. Epidemiology of Chronic Non-Communicable Diseases and conditions- Blindness. In: K Park, editor. Park’s Textbook of Preventive and Social Medicine.21st ed. Jabalpur (MP): M/s Banarsidas Bhanot. 2011:370-72.
Sihota R, Tandon R. The causes of and Prevention of Blindness. In: Ramanjit Sihota, Radhika Tandon, eds. Parsons’ Diseases of the Eye. 20th ed. New Delhi: Elsevier, A Division of Reed Elsevier India private Limited. 2007;523-24:529.
Khurana AK, Khurana B. Community Ophthalmology. In: AK Khurana, editor. Comprehensive Ophthalmology. 5th ed. New Delhi: New Age International (P) Ltd. 2012:474-78:482-84.
Thylefors B1. Epidemiological patterns of ocular trauma. Aust N Z J Ophthalmol. 1992;20(2):95-8.
Shukla B, Natarajan S. New classification systems for ocular trauma, Appraisal of new classification of Ocular Trauma, Corneal injuries. In: B. Shukla, S. Natarajan eds. Management of Ocular Trauma.1sted.New Delhi: CBS Publishers & Distributors Pvt.Ltd. 2005:8- 9,12-13,89-94.
Kanski JJ, Bowling B. Trauma. In: Jack J Kanski, Brad Bowing, eds. Clinical Ophthalmology – A Systematic Approach. 7th ed. China: Elsevier Saunders. 2011:885.
Krishnaiah S, Nirmalan PK, Shamanna BR, Srinivas M, Rao GN, Thomas R. Ocular trauma in a rural population of southern India: the Andhra Pradesh Eye Disease Study. Ophthalmology. 2006;113(7):1159-64.
Nirmalan PK, Katz J, Tielsch JM, Robin AL, Thulasiraj RD, Krishnadas R et al. Ocular trauma in a rural south Indian population: the Aravind Comprehensive Eye survey. Ophthalmology. 2004;111(9):1778-81.
Dandona L, Dandona R, Srinivas M, John RK, McCarty CA, Rao GN. Ocular trauma in an urban population in southern India: the Andhra Pradesh Eye Disease Study .Clin Experiment Ophthalmol. 2000;28(5):350-56.
Voon LW, See J, Wong TY. The epidemiology of ocular trauma in Singapore: Perspective from the emergency service of a large tertiary hospital. Eye. 2001;15:75-81.
Zagelbaum BM, Tostanoski JR, Kerner DJ, Hersh PS. Urban eye trauma: A one-year prospective study. Ophthalmology. 1993;100(6):851-56.
Klopfer J, Tielsch JM, Vitale S, See LC, Canner JK. Ocular trauma in the United States: Eye injuries resulting in hospitalization, 1984 through 1987. Arch ophthalmol. 1992;110(6):838-42.
Eagling EM. Perforating injuries of the eye. Br J Ophthalmol. 1976;60:732-6.
Roper-Hall MJ. Control of astigmatism after surgery and trauma. Birmingham British Journal of Ophthalmology. 1982;66:556-9.
Navon SE. Topography after repair of full-thickness corneal laceration. J Cataract Refract Surg. 1997;23(4):495-501.
Vora GK, Haddadin R, Chodosh J, MPH. Management of Corneal Lacerations and Perforations. Int Ophthalmol Clin. 2013;53(4):1-10.