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Matthew Wade, Sumit Garg, Marjan Farid, Roger F Steinert; Femtosecond Laser Enabled Penetrating Keratoplasty With Zig-Zag Incision: Suture-Pattern Comparison and Suture-Out Results. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3127.
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© ARVO (1962-2015); The Authors (2016-present)
To report visual and astigmatism outcomes in patients who underwent zig-zag femtosecond laser enabled keratoplasty (FLEK) with subsequent full suture removal. To evaluate the effect of suture pattern on suture-out endpoints.
Retrospective study at a referral academic practice evaluating uncorrected and corrected distance visual acuity (UDVA, CDVA) as well as manifest (Mrx cyl) and topographical (Topo cyl) astigmatism. 108 eyes underwent suture removal; data are presented for the 83 eyes estimated to have good visual potential (> 20/30). Suture patterns included: running (R) (N=58), interrupted (I) (N=19), combined (C) (N=7). Assignment to suture pattern group was not random (e.g. vascular corneas were assigned interrupted sutures, whereas avascular corneas were more often assigned running sutures).
Full suture removal occurred on average 1.2 years [standard deviation 0.7] after FLEK. The pre vs post suture removal values were significant only for CDVA (showing improvement): UDVA from mean LogMar 0.74 [SD 0.45] to 0.68 [SD 0.45] (P=0.687), CDVA from 0.28 [SD 0.22] to 0.23 [SD 0.19] (P=0.024), Mrx cyl from 3.57 [SD 1.83] to 3.48 [SD 2.12] (P=0.906) and Topo cyl from 5.33 [SD 3.83] to 5.71 [SD 5.41] (P=0.547). No significant difference in outcomes were found between the different suture patterns in mean LogMar UDVA (R=0.72 [SD 0.47], I=0.82 [SD 0.41], C=0.66 [SD 0.48]), CDVA (R=0.24 [SD 0.18], I=0.41[SD 0.28], C=0.29 [SD 0.19]), Mrx cyl (R=3.15 [SD 1.76], I=4.58 [SD 1.47], C=4.04 [SD 2.39]) or Topo cyl (R=4.73 [SD 3.82], I=7.18 [SD 3.60], C=4.82 [SD 3.25]) (P>0.05 for all suture type comparisons). Results will be updated prior to presentation.
The zig-zag FLEK incision results in good vision and astigmatism after suture removal. Suture pattern did not statistically influence final suture out results although group sizes were asymmetric.
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