Complications of Mersilene sutures in penetrating keratoplasty.
BACKGROUND
After penetrating keratoplasty, many corneal surgeons adjust sutures to reduce astigmatism and then leave the sutures in place indefinitely. Nylon sutures can hydrolyze and break years after surgery. In a series of human penetrating keratoplasties, we studied the use of polyester (Mersilene) sutures that do not hydrolyze.


METHODS
We performed two prospective studies of polyester (Mersilene) sutures in human penetrating keratoplasty done by one surgeon. Study I was a randomized comparison of combined running and interrupted Mersilene and nylon sutures in 45 consecutive eyes. Study II was a case series of single running Mersilene suture with postoperative adjustment of suture tension to manage astigmatism in 23 consecutive eyes. We evaluated the performance of the suture and the control of astigmatism.


RESULTS
The interrupted running suture study demonstrated that interrupted Mersilene sutures were 5.5 times more likely to have handling-related complications than nylon interrupted sutures (p = .01); in addition, they were three times as likely to have tissue-related complications as nylon (p = .16). The running suture study demonstrated an unacceptable complication rate of 69% when Mersilene was used as a single adjustable running suture. At 6 months postoperatively, the median refractive astigmatism for the adjustable cases was 3.37 diopters (mean, 4.03 +/- 2.37 D). Eyes with significant suture-related complications were 2.85 times more likely to have greater than 4.00 D of refractive astigmatism than were eyes without suture-related complications.


CONCLUSIONS
Mersilene is an undesirable suture for use in penetrating keratoplasty.
Bertram
B A
BA
Emory University School of Medicine, Department of Ophthalmology, Atlanta, GA 30322.
Drews-Botsch
C
C
Gemmill
M
M
Guell
J
J
Murad
M
M
Waring
G O
GO
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001251:Astigmatism / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D009757:Nylons; D011093:Polyethylene Terephthalates / Q000009:adverse effects*; D011183:Postoperative Complications; D011446:Prospective Studies; D013536:Suture Techniques; D013537:Sutures / Q000009:adverse effects*
D009757:Nylons; D011093:Polyethylene Terephthalates; C025539:Lavsan