J Korean Med Sci.  2008 Dec;23(6):1015-1019. 10.3346/jkms.2008.23.6.1015.

The Effect of Different Suturing Techniques on Astigmatism after Penetrating Keratoplasty

• Kim SJ
• Wee WR
• Lee JH
• Kim MK

• KMID: 1107527
• DOI: http://doi.org/10.3346/jkms.2008.23.6.1015

Abstract

The purpose of this study was to compare the effects on astigmatism after penetrating keratoplasty with three different suture techniques. In this prospective study, 38 eyes of 38 patients underwent penetrating keratoplasty with three suturing techniques: interrupted, single running, and double running. Topographic astigmatism was measured at 2, 6, 12, and 18 months after keratoplasty. During 18 months after surgery, the interrupted suture group had higher astigmatism than the double running suture group. There was no significant difference in the amounts of astigmatism during the first year after keratoplasty between the single running and the double running suture group. However, at 18 months after surgery, when all sutures were out, the double running suture group (3.60+/-1.58 diopters) showed significantly less astigmatism than the single running group (5.65+/-1.61 diopters). In conclusion, post-keratoplasty astigmatism was the least in the double running suture group of the three suturing techniques at 18 months after penetrating keratoplasty.

Keyword

Astigmatism; Keratoplasty, Penetrating

MeSH Terms

Adult
Astigmatism/etiology/*prevention & control
Corneal Diseases/surgery
Corneal Topography
Female
Humans
*Keratoplasty, Penetrating
Male
Middle Aged
Postoperative Complications
Prospective Studies
*Suture Techniques
Time Factors
Visual Acuity

Figure

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  Fig. 1 Three suturing techniques in penetrating keratoplasty; interrupted (A), double running (B), and single running (C).

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  Fig. 2 Topographic astigmatism of representative cases with three different suture techniques by the Orbscan topographic system (A: interrupted suture, B: double running suture, C: single running suture). All three were done 12 to 18 months after surgery, when all the sutures were removed.

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  Fig. 3 The changes in astigmatism measured with the Orbscan (Orbtek Inc. Salt Lake City, UT, U.S.A.) at 2, 6, 12, and 18 months after penetrating keratoplasty in three groups. INT, DRS, and SRS represent interrupted suture, double running, and single running suture, respectively. Horizontal bars represent two standard errors of mean (SEM). *, Significantly different (p<0.05, Mann-Whitney U test) compared to other two groups, respectively; †, significantly different (p<0.05, Mann-Whitney U test) between INT and DRS groups.

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  Fig. 4 Topographic astigmatism (Diopters, mean±SD) before initial suture removal and three months after suture removal in each suturing technique groups. INT, DRS, and SRS represent interrupted suture, double running, and single running suture, respectively. Horizontal bars represent two standard errors of mean (SEM). *, Significantly different astigmatism between before initial suture removal and three months after suture removal (p<0.05, Wilcoxon matched pairs signed ranks test).

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