title: Inadequacy of a polyester (Mersilene) suture for the reduction of astigmatism after penetrating keratoplasty.
abstract: Through two prospective studies, we evaluated the use of polyester (Mersilene) sutures in penetrating keratoplasty. Study 1 was a randomized comparison of combined running and interrupted Mersilene and nylon sutures (n = 45). Study 2 was a case series of single running Mersilene with postoperative adjustment of suture tension to manage astigmatism (n = 23). Study 1 demonstrated that Mersilene interrupted sutures were 5.5 times more likely to have handling-related complications compared to nylon (P = 0.01); in addition, they were 3 times as likely to have tissue-related complications as nylon interrupted sutures (P = 0.16). Study 2 demonstrated a 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 D (mean, 4.03 +/- 2.37 D). Eyes in Study 2 with significant suture-related complications were 2.85 times more likely to have greater than 4 D of refractive astigmatism than were eyes without suture-related complications. We concluded that Mersilene is an undesirable suture for use in penetrating keratoplasty.
authors.affiliation: Emory University Medical School, Department of Ophthalmology, Atlanta, Georgia.
authors.forename: B A
authors.initials: BA
authors.lastname: Bertram
authors.forename: C
authors.initials: C
authors.lastname: Drews
authors.forename: M
authors.initials: M
authors.lastname: Gemmill
authors.forename: J
authors.initials: J
authors.lastname: Guell
authors.forename: M
authors.initials: M
authors.lastname: Murad
authors.forename: G O
authors.initials: GO
authors.lastname: Waring
mesh_terms: D000328:Adult; D000368:Aged; D001251:Astigmatism / Q000601:surgery*; D003316:Corneal Diseases / Q000209:etiology; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D009757:Nylons; D010795:Phthalic Acids / Q000009:adverse effects*; D011092:Polyethylene Glycols / Q000009:adverse effects*; D011093:Polyethylene Terephthalates; D011446:Prospective Studies; D013536:Suture Techniques; D013537:Sutures
chemical_list: D009757:Nylons; D010795:Phthalic Acids; D011093:Polyethylene Terephthalates; C025539:Lavsan; D011092:Polyethylene Glycols