Corneal astigmatism after penetrating keratoplasty. The role of suture technique.
A randomized clinical trial was conducted to contrast two techniques of suturing in penetrating keratoplasty (PK) surgery: double running 10-0 and 11-0 sutures (DR), and a combination of 12 interrupted 10-0 sutures with a single running 11-0 suture (IR), followed by selective suture removal. The primary outcome evaluated in the 60 patients within each group was keratometric astigmatism. A decreasing trend in astigmatism over postoperative year 1 was observed only in the IR group (from 4.00 diopters [D] at 3 months to 2.50 D at 12 months). The difference in median astigmatism at 1 year (IR, 2.50 D; DR, 4.00 D) approached statistical significance (P = 0.06, Mann-Whitney U test). Both groups showed comparable steepening of almost 1 D during postoperative year 1. Assessment of the rate of visual rehabilitation was limited by a greater proportion of IR patients showing cystoid macular edema (CME) after surgery. These results, while favorable toward the IR/selective suture removal technique, must be substantiated by a final assessment after all sutures have been removed.
Musch
D C
DC
W. K. Kellogg Eye Center, Department of Ophthalmology, University of Michigan, Ann Arbor 48105-1994.
Meyer
R F
RF
Sugar
A
A
Soong
H K
HK
D000368:Aged; D001251:Astigmatism / Q000209:etiology*; D016039:Corneal Transplantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008269:Macular Edema / Q000150:complications; D008297:Male; D011184:Postoperative Period; D011897:Random Allocation; D013536:Suture Techniques; D014792:Visual Acuity