Effect of suturing on latrogenic keratectasia after laser in situ keratomileusis.
OBJECTIVE
To evaluate the influence of corneal suturing on the clinical course of iatrogenic keratectasia after laser in situ keratomileusis (LASIK), in order to improve quality of vision and to avoid progressive deterioration of visual acuity.


METHODS
Three patients (four eyes) who had a perforation during LASIK or became keratectatic after LASIK received corneal suturing with 10-0 nylon immediately or up to 11 days after LASIK. Sutures were left in place for 1 to 4 months. Patients were followed for 20 to 23 months after suturing.


RESULTS
All eyes had a significant improvement in uncorrected and best spectacle-corrected visual acuity after suturing. The improvements in visual acuity for all patients remained unchanged after suture removal. In patient 1, keratectatic changes were not detected in the sutured eye although they were detected in the contralateral unsutured eye. In patient 2, both eyes were sutured, one immediately and the other 11 days after LASIK; no keratectatic changes were noted in either eye. Slight progression of corneal protrusion was observed in patient 3, who had corneal suturing after development of prominent keratectasia 2 weeks after LASIK. This eye showed stable but moderate keratectatic change 9 months after suture removal.


CONCLUSIONS
Flap suturing in patients during the course of keratectasia after LASIK improved both aided and unaided visual acuity. Prompt suturing seemed to provide a means of preventive management for iatrogenic keratectasia in anticipation of keratoplasty.
Seo
Kyoung Yul
KY
Department of Ophthalmology, Yonsei Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
Lee
Joon H
JH
Kim
Moon J
MJ
Park
Jung Won
JW
Chung
Eui Sang
ES
Lee
Young S
YS
Kim
Eung Kweon
EK
D000328:Adult; D003315:Cornea / Q000473:pathology / Q000601:surgery*; D003316:Corneal Diseases / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery; D065306:Corneal Injuries; D019781:Corneal Topography; D004108:Dilatation, Pathologic / Q000209:etiology / Q000517:prevention & control / Q000601:surgery; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease / Q000517:prevention & control*; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D012421:Rupture; D013524:Surgical Flaps; D013536:Suture Techniques; D014792:Visual Acuity / Q000502:physiology