الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Congenital cataract is the leading cause of treatable childhood blindness around the world. It has a good prognosis if its early detected and managed. The prognosis of developmental cataract is better than that of congenital cataract. The primary goal of treatment is to clear the visual axis, followed by postoperative visual rehabilitation. Pediatric surgery differs from adult surgery in that children have lower corneal and scleral rigidity, a very elastic anterior capsule, a soft lens, and a well-formed vitreous. Moreover, children are more liable to postoperative trauma and eye rubbing cannot be completely avoided. All that makes sutured incisions preferable in pediatric cataract surgeries. The surgeon must decide the appropriate type of suture and needle, suture placement, and knot type to minimize tissue trauma and maximize wound healing. Regardless of the used approach, options for suturing surgical wounds include 10/0 Nylon and 10/0 Vicryl sutures. There was still some debate about which of the two sutures would be a better option in children. In the present study;10/0 monofilament Nylon sutures and 10/0 monofilament Vicryl sutures were compared in 72 eyes of 45 pediatric patients who underwent surgeries for congenital /developmental cataract in Mansoura Ophthalmic Center (36 eyes their incisions were sutured with 10/0 Nylon sutures and the other 36 eyes their incisions were sutured with 10/0 Vicryl sutures each group was subdivided into 2 subgroups Subgroup (A) Aphakia with 2 limbal incisions each sutures with one suture and subgroup (B) Pseudophakia with 2 limbal incisions and one main incision: each of the two limbal incisions was sutured with one suture while the main incision was sutured with 2 sutures. Changes in average Keratometric values, corneal astigmatism central corneal thickness, suture related complications and time for suture removal were compared in both groups. The study showed that there were no statistical significant differences as regard the mean K-readings, the corneal stigmatism and central corneal thickness between both groups at the end of the follow up period. Although; Vicryl group, showed more gradual decrease in postoperative corneal astigmatism and mean K values when compared to Nylon group in the early postoperative period (until Nylon suture removal by the 3rd week postoperative). As regard to the cornea opacity grading among both groups, corneal opacity grade in Vicryl group was significantly higher than that of the Nylon group at the end of the follow up period. The comparison between Nylon and Vicryl groups regarding suture-related complications during the follow-up period in the current study showed that mucous infiltration and loose sutures were more among the Vicryl group than Nylon group and in these eye the density of suture related opacity increased earlier than the others. While the number of cut sutures, was slightly higher in the Nylon group with most of cases occurred in the 2nd or 3rd day postoperative and there was no significant difference between the two groups in the incidence of suture related vascularization, although the 2 eyes with retained segment of Nylon sutures experienced dense vascularization suture related opacity. The mechanical properties of both suture materials under the study were compared under the same environmental circumstances. The comparison revealed that that 10-0 monofilament Nylon suture slightly stiffer than 10-0 monofilament Vicryl suture and resists the minor deformation. Conclusion : Although, there is still debate about which of the two sutures would be a better option in pediatric cataract surgeries; the current study found that, while absorbable Vicryl sutures eliminate the need for suture removal under general anesthesia after pediatric cataract surgeries, they cause more tissue reaction, have a greater opacity density, and are more expensive than non-absorbable Nylon sutures.