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Impressum
Effect of single versus double running suture on corneal astigmatism and suture loosening after penetrating keratoplasty
1Heyer C., 2Rank R. M., 2Budde W. M., 1Jonas J. B.
1Department of Ophthalmology, Faculty of Clinical Medicine Mannheim of the University Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; 2Department of Ophthalmology and Eye Hospital, Friedrich-Alexander- University Erlangen-Nürnberg, Schwabachanlage 6, 91054 Erlangen, Germany
Purpose: To examine the effect of single versus double running
suture on corneal astigmatism in patients undergoing penetrating allogenic
keratoplasty as treatment of Keratokonus and Fuchs´ corneal endothelial
dystrophy.
Patients and Methods: The retrospective comparative clinical interventional
study included all 101 patients who underwent penetrating allogenic keratoplasty
as treatment of Keratokonus or as treatment of Fuchs´ corneal endothelial
dystrophy, and who were operated on by the same surgeon. A single running
10-0 nylon suture was used for all patients operated on in the first part
of the study from 1989 to 1992 (n=44 patients). A double running 10-0
nylon suture was used for all patients operated on in the second part
of the study from 1992 to 1997 (n=57 patients). Both study groups did
not vary significantly (P>0.05) in gender of donors and patients, age
of donors and patients, time between death of the donor and enucleation
of the globes, time of the corneal graft in the cornea storage medium,
and right or left eye of the patient. Besides using the double versus
the single running suture, the surgical technique was not markedly different
between the two study groups.
Results: Suture loosening occurred in significantly (p<0.001;
Chi-Square-test) more in the patients with a single running suture than
in the patients with double running suture. Postoperative refractive and
keratometric astigmatism was lower, however not significantly lower (P>0.10),
in the group with double running suture compared with the group with a
single running suture.
Conclusions: In penetrating keratoplasty for Keratokonus or Fuchs´
corneal endothelial dystrophy, a double running suture in comparison to
a single running suture may be helpful in decreasing the rate of suture
loosening. It does not have a major impact on the degree of corneal astigmatism.