Advantages of Double Running Sutures in Astigmatism After Penetrating Keratoplasty

Abstract

Background

The purpose of this prospective study is to evaluate the effects of different suturing techniques in perforating keratoplasty surgery, in order to identify the most effective in reducing post-operative astigmatism.

Methods

We analysed data from patients who underwent penetrating keratoplasty for different indications. All interventions were performed by the same surgeon. Patients were subjected to a follow-up of at least 12 months after surgery, during which astigmatism (assessed by keratometry, topography and refraction) best-corrected visual acuity (BCVA) and complications were evaluated. A total of 100 eyes from 100 patients were included and were randomly assigned to five different groups, each one featuring a different suturing technique: interrupted (INT), single running (SRS), double running with two 10–0 sutures (DRS), double running antitorque with two 10–0 sutures (DRSa), double running with both 10–0 and 11–0 sutures (DRS with 11–0).

Results

There is a statistically significant difference in astigmatism after surgery between the double running sutures groups and the others with different techniques. However, there is no statistically significant difference between the INT and the SRS group; moreover, there is no statistically significant difference between the different groups with double running sutures (DRS, DRSa, DRS with 11–0). There is no statistically significant difference in BCVA values among the five groups. The wound leak rate was 10% in the INT group, 5.3% in the SRS group and 0% in all groups with double running sutures.

Conclusion

In penetrating keratoplasty surgery, the double running suture technique reduces postoperative astigmatism, provides faster visual rehabilitation and features lower complication rates when compared to techniques featuring single running and interrupted sutures. No significant difference in terms of postoperative astigmatism or complication rates was observed among patients receiving double running suture techniques.

Keywords:

• astigmatism
• penetrating keratoplasty
• corneal suture technique
• running suture
• interrupted suture

Ethics and Consent to Participate

All procedures in this study concerning his conduction and documentation were performed in conformity with the ethical principles set out in the Helsinki Declaration and its revisions. This prospective study was approved by the Ethics Committee of “Città della Salute e della Scienza di Torino” (University of Turin). Consent to participate was obtained in written form and has been registered for all subjects of this study. All participants were informed about the purpose of the study.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that there are no conflicts of interest regarding the publication of this paper.