Changes in Corneal Curvature after Suture Removal in Penetrating Keratoplasty

PURPOSE: To investigate the changes in corneal curvature after suture removal in penetrating keratoplasty. METHODS: Forty-six patients who underwent penetrating keratoplasty without any other surgery which may affect on the corneal keratometric values were included, and their data were retrospectively reviewed. The mean follow-up was 11.5 months and the average donor-recipient size gap was 0.47 mm. Corneal curvature was estimated by the Simulated Keratometric index in 17 eyes with continuous sutures and in 29 eyes with interrupted sutures. The changes of corneal curvature were compared between suture-removed and not suture-removed groups. RESULTS: In patients with continuous suture, the corneal curvature increased significantly from 47.12D at 5.1 months to 49.30D at 10.6 months after suture removal (p=0.002); in patients with interrupted suture, corneal curvature increased from 37.93D at 4.1 months to 42.44D at 11.5 months (p<0.001) after an average removal of 4.23 interrupted sutures, but it was not changed in each not suture-removed groups. CONCLUSIONS: Corneal curvature increased, on average, by 2.18D after one continuous suture removal and by 2.26D after an average of 2.12 interrupted sutures removal in penetrating keratoplasty. Prediction of keratometric value after removal of the sutures can be helpful to determine intraocular lens power in cataract surgery simultaneously combined with penetrating keratoplasty.

Changes in Astigmatism after Suture Removal in Penetrating Keratoplasty

PURPOSE: To study a refractive change after suture removal and to evaluate some factors for this change in penetrating keratoplasty. METHODS: We studied 53 eyes of 47 patients who had undergone penetrating keratoplasty. Subjective refraction and best corrected visual acuity were measured in all eyes before and after the removal of sutures. We also classified the subject eyes based on suture removal time, degree of astigmatism before suture removal, recipient trephine size and compared the change of astigmatism within the groups. RESULTS: Suture removal decreased the astigmatism by an average of 0.81 diopter (D) (p=0.02) and increased the best corrected visual acuity by an average of 0.17 (p=0.005). These results show that corneal astigmatism tends to decrease more with early suture removal (p=0.010), higher degree of astigmatism before suture removal (p<0.05) and smaller size of recipient trephine (p=0.014). CONCLUSIONS: The removal of entire suture after penetrating keratoplasty decreases corneal astigmatism. Furthermore, the outcome is influenced by suture removal time, degree of astigmatism before suture removal, and recipient trephine size.

Usefulness of Early Suture Removal Using Adhesive Skin Tape in Appendectomy

PURPOSE: Despite plenty of evidence that the healing of skin wounds is fostered by the use of skin tape and early suture removal, the technique has not been widely practiced. In order to investigate the combined technique of early suture removal using skin tape, we compared it with conventional suture removal. METHODS: We analyzed, retrospectively, 260 patients who underwent on appendectomy during 1999 to compare the two methods on the basis of age, sex, wound infection by class and incision type, cosmetic effect, and other suture site complication, including seroma, hematoma, dehiscence, and pain. RESULTS: Out of these 260 patients, 124 had conventional suture removal while 136 had early suture removal using skin tape. In the group of early suture removal using skin tape, there were a lower incidence of seroma, hematoma, and wound infection, a shorter period of postoperative wound pain, and superior cosmetic results and patient acceptability. CONCLUSION: We have found the combined technique to have advantages that produce a lower incidence of wound complication with a superior cosmetic result and an excellent patient acceptance.