Effect of Adjusting of the Continuous (running) Corneal Suture on the CylindricalRefraction after Penetrating Keratoplasty

Authors: J. Urminský;  P. Rozsíval;  V. Lorencová;  N. Jirásková
Authors‘ workplace: Oční klinika FN a LF UK, Hradec Králové, přednosta prof. MUDr. P. Rozsíval, CSc.
Published in: Čes. a slov. Oftal., , 2004, No. 2, p. 124-132


Authors refer about the effect of adjusting (adjustment of the suture tension) ofthe running corneal suture on the final cylindrical refraction in patients whounderwentpenetratingkeratoplastyduetokeratoconus.Inourarticleweevaluatetwo groups of patients.The group I consists 76 patients (76 eyes) who regularly visited our department ofophthalmology. There were 52.6 % of females and 47.4 % ofmales. The average ageat the time of surgery was 33.5 ± 5.2 years (range, 18 – 52 years). In this group ofpatients, the adjusting was performed during the surgery.In the group II 35 patients (40 eyes) underwent the adjusting procedure of therunning corneal suture in the early postoperative period. There were 19 (54.0 %)women and 16 (46.0 %) men. The average age of the whole group at the time ofsurgery was 34.6 ± 3.8 years (range, 18 – 50 years). The indication to carry out theadjusting was topographically verified astigmatism of more then 3.5 cylindricaldiopters (D cyl). The purpose of this study was to find the ultimate surgery technique to get notonly the clearness and good healing of the corneal graft, but first of all to preventextensiveametropia alreadyduringthesurgery.In theearly stageafter thesurgerywe are trying to reduce emerged refractive error and to get faster recovery of goodvisual acuity of the operated eye.In the sense of the least final postoperative astigmatism, the best results we havereached in cases where the donor corneal graft was 0.25 mm larger in diameterand the suture was adjusted during the surgery using light circles according toSerdarevic. In this group of patients the average final cylindrical refractive errorafter the surgery was 2.00 ± 0.81 D cyl. When adjusting the corneal suture inpostoperative period, the mean final refractive error decreased of about 3.09 ± 1.62D cyl.penetrating keratoplasty, adjusting of the corneal suture, cylindricalrefraction.

Key words:
penetrating keratoplasty, adjusting of the corneal suture, cylindricalrefraction.

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