Abstract

SA.09.04

Postkeratoplasty astigmatism – a comparison of three suturing techniques

Iryna Naydis, Maren Klemm, Andrea Hassenstein, Toam Katz, Gisbert  Richard, Stephan Linke
Universitäts-Augenklinik, Universitätsklinikum Hamburg-Eppendorf, Hamburg

Objective
To compare the effect of 3 common suturing techniques on postkeratoplasty astigmatism and best corrected visual acuity (BCVA) in patients undergoing penetrating keratoplasty (PK).
Methods
In this retrospective analysis 150 eyes underwent PK with 3 suturing techniques: single running (SR), double running (DR-counterclockwise), and interrupted (IR). 46 eyes (30,7%) had KP for Fuchs endothelial dystrophy, 33 eyes (22%) for keratoconus, 12 eyes (8%) for herpetic keratitis and 7 eyes (4,6%) for pseudophacic bullous keratopathy. For trepanation GTS system was used in 44%, rotortrepan in 46,6%, and best trepan in 5,3%. Postkeratoplasty astigmatism and best corrected visual acuity (BCVA) were evaluated 4 months and 2 years after surgery (all sutures removed). Subjective-, objective refraction and corneal topography were performed to asses astigmatism.
Results
37 eyes (24,7%) underwent PK with single running sutures, 81 eyes (54%) with double running sutures, and 32 eyes (21,3%) had interrupted sutures. Mean astigmatism (subjective refraction) 4 months after surgery was 4,5 ± 3,07 (SR), 3,2 ± 2,04 (DR), and 6,2 ± 1,61 (IR) D in the 3 groups, respectively. Two years after surgery mean astigmatism was 4,9 ± 1,8 for SR, 3,5 ± 1,98 for DR, and 4,7 D for IR suturing technique. BCVA 2 years post keratoplasty was 0,43 ± 0,15 (SR), 0,54 ± 0,3 (DR), and 0,45 ± 0,27 (IR), respectively.
Conclusions
In this retrospective analysis DR suturing technique showed most favorouble outcome regarding postkeratoplasty astigmatism and BCVA in the 2 year follow-up period. Mean astigmatism increased slightly after removal of continuous sutures, but decreased significantly after IR removal.

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