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N. N. Desai, R. F. Steinert; Femtosecond Laser Keratoplasty: Suture Removal and Impact on Astigmatism. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1121. doi: https://doi.org/.
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Femtosecond laser keratoplasty (FLK) potentially creates improved precise tissue alignment, increased wound stability and less topographical irregularity than conventional trephine blade penetrating keratoplasty. This study examines the effect of suture removal on refractive and topographical astigmatism in FLK patients.
Retrospective chart review identified patients who had suture removal after zig-zag incision FLK with both 1 and 3 month follow-up and measurements. Topographical simK astigmatism was measured by either Orbscan or Pentacam and by manifest refraction prior to suture removal and at 1 and 3 months after suture removal. Either a 24-bite running suture or a 16-bite running suture with 8 interrupted sutures was employed for these grafts. Eyes that had secondary surgical procedures or wound manipulation within the postoperative period were omitted. Data was compiled in a database and a paired t-test was used for statistical calculations.
10 eyes qualified for analysis. Average refractive cylinder before suture removal was 4.22 diopters and average topographical astigmatism was 3.54 diopters. After suture removal, the average refractive and topographical astigmatism at 1 month was 5.25 and 6.42 diopters respectively. At 3 months, the average refractive and topographical astigmatism was 3.85 and 4.72 diopters respectively.
Suture removal in these eyes show an initial increase in refractive (p=0.2553) and topographical (p= 0.0471) astigmatism at 1 month with a subsequent trend towards decreased astigmatism at 3 months (p=0.5299 for refractive K and p=0.3779 topographical K) similar to the pre-suture removal baseline.
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