title: Effect of suturing on latrogenic keratectasia after laser in situ keratomileusis.
abstract: 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.
authors.affiliation: Department of Ophthalmology, Yonsei Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Kyoung Yul
authors.initials: KY
authors.lastname: Seo
authors.forename: Joon H
authors.initials: JH
authors.lastname: Lee
authors.forename: Moon J
authors.initials: MJ
authors.lastname: Kim
authors.forename: Jung Won
authors.initials: JW
authors.lastname: Park
authors.forename: Eui Sang
authors.initials: ES
authors.lastname: Chung
authors.forename: Young S
authors.initials: YS
authors.lastname: Lee
authors.forename: Eung Kweon
authors.initials: EK
authors.lastname: Kim
mesh_terms: 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