Early Visual Recovery in Keratoconus Patients Undergoing Penetrating Keratoplasty With a Single Running Suture Versus a Combined Running and Interrupted Suture Technique

Abstract

Abstract: : Purpose:To compare early visual recovery in postkeratoplasty keratoconus patients using two different suturing techniques. Methods:A retrospective study of 24 penetrating keratoplasties performed by one surgeon (HK) on keratoconus patients at The Krieger Eye Institute between 1991 and 2000 was performed. In one group of 12 eyes a single running 10-0 nylon suture was used and in the second group of 12 eyes a combination of 12 10-0 nylon interrupted and a 10-0 nylon running suture was used. In group 1 no postoperative suture adjustment was performed and the suture was left in place for a least one year. In group 2 interrupted sutures were removed postoperatively during the first year based on corneal topography. Results:There were 12 eyes in each group. The average age and pre-operative visual acuity was 36.1(+/-10) years and 1.07 (+/- 0.50) log mar in group 1 and 37.8 (+/- 6) years and 1.22(+/- 0.28) log mar for group 2. The average improvement in vision post-operatively at 1 week was 0.48(+/-0.54) in group 1 and 0.08(+/-0.60) in group 2. The improvement at 3 months in group 1 was 0.88(+/- 0.16) and in group 2 was 0.23 (+/-0.51). At 6 months the improvement in group 1 was 0.80(+/-0.47) and was 0.27(+/-0.44) in group 2. At 1 year the improvement in group 1 was 0.95 (+/- 0.37) and in group 2 was 0.69 (+/-0.56). Conclusion:During the first year after penetrating keratoplasty with a single running suture technique without postoperative suture adjustment (group 1), postoperative visual recovery in keratoconus patients occurs more rapidly than in an age matched population (group 2) using a combined interrupted and running suture technique by the same surgeon.

Keywords: 450 keratoconus • 353 clinical (human) or epidemiologic studies: outcomes/complications • 607 transplantation