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Payam Morgan, Ken Lin, Mathew Wade, Amir Pirouzian, Sumit Garg, Marjan Farid, Ronald Gaster, Roger Steinert; Impact Of Early Vs. Late Suture Removal On Astigmatism And Visual Acuity In Femtosecond Laser Keratoplasty. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6055.
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To evaluate whether the timing of suture removal (early vs. late) after femtosecond laser enabled keratoplasty (FLEK) leads to significant difference in astigmatism and visual acuity.
42 eyes of 42 patients who had had complete suture removal after FLEK were analyzed. At surgery, 7 eyes received 8 combined interrupted sutures with a 16-bite running suture and the remaining 39 received single 24-bite running suture with 10-0 nylon. All eyes had zig-zag pattern FLEK incisions. The early suture removal group consists of patients whose sutures were removed between 3-9 months post-operatively (n=18), healing vs. elective. The late suture removal group consists of those whose sutures were removed between 1 to 2 years post-operatively (n=24). Uncorrected and corrected visual acuity and topographic delta simKs were measured 6 months after suture removal.
There was no significant difference in both uncorrected and best-corrected visual acuity (BCVA) between the early and the late suture removal groups (BCVA: 0.501 +/- 0.369 vs. 0.544 +/- 0.424 in early vs. late suture removal). There was also no statistically significant difference in astigmatism between the two groups (5.1+/- 4.3 in early vs. 3.9 +/- 2.5 in late suture removal). However, a possible trend towards less astigmatism and less variability in the late suture removal group was observed.
After femtosecond keratoplasty, early suture removal within a year postoperatively does not appear to affect visual acuity compared to sutures removed at later time points. Astigmatism analysis will benefit from larger numbers of eyes in the database with further enrollment.
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