97th DOG Annual Meeting 1999
V47
CORNEAL SUTURE RING
J. H. Krumeich, J. Daniel, B. Krumeich
Purpose: Prevention of high astigmatism after perforating keratoplasty
Beside identical dimensions of donor button and recipient bed tension-free matching of donor cornea is a prerequisite for prevention of high post PKP astigmatism. Even suture fixation in the peripheral cornea is frequently impossible because of soft or thinned-out tissue and/or asymmetrical suture. The resulting vectors of suture traction forces are not symmetrical and of unequal values.
Method: The apposition of a steel-Titanium-Molybdan alloy ring in the donor button and recipient bed allows tension-free adaptation of both wound faces. Irregular or uneven vectors are neutralized at the ring. The double-running antitorque suture was placed around the titanium ring of 0,15 mm thickness.
Results: 18 eyes with keratoconus or endo-epithelial dystrophy at a follow-up of 2 years and 30 eyes of 1 year: mean best corrected visual acuity (BCVA) was 20/50 after 1 month, 20/40 after 3 month, 20/40 after 6 months with large Standard Deviation. The ring was taken out after 1 year. Astigmatism was between 1,5 and 3 D in 44 cases, in 4 cases between 3 and 4,5 D. After ring removal BCVA worsened through a period of 4-6 weeks. Astigmatism was unchanged in 35 cases (70 % ), the remaining cases being still under evaluation.
Complications: 1 allergical reaction after 1 year, with ring removal uneventful healing.
Conclusion: The corneal suture ring improves the postop course and diminishes astigmatism in perforating corneal transplants.
Martin-Luther Hospital, Eye Department, Voedestr. 79, D-44866 Bochum, Germany
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