Running nylon suture dissolution after penetrating keratoplasty

Area of Science:

• Ophthalmology
• Corneal Surgery
• Biomaterials Science

Background:

• Early post-keratoplasty astigmatism is a significant concern impacting visual outcomes.
• Combined interrupted/running suturing techniques aim to achieve initial low astigmatism.
• Long-term stability of astigmatism after keratoplasty is crucial for patient vision.

Purpose of the Study:

• To evaluate the long-term maintenance of low astigmatism achieved with a combined suturing technique.
• To assess the impact of suture integrity on post-keratoplasty astigmatism over an extended period.

Main Methods:

• A cohort of 25 eyes (patients) was monitored for 13 to 70 months post-keratoplasty.
• Patients had undergone a combined suturing technique using 12 interrupted 10-0 nylon and one running 11-0 nylon suture.
• Keratometric astigmatism was measured, and suture integrity was assessed throughout the follow-up period.

Main Results:

• Spontaneous breakage of the 11-0 nylon running suture occurred in nine eyes.
• Suture breakage led to a significant increase in mean keratometric astigmatism from 1.7 to 3.4 diopters.
• A mean vector-corrected astigmatism increase of 4.9 diopters was observed after suture disruption, often necessitating further surgical intervention.

Conclusions:

• 11-0 nylon is not an ideal material for running sutures in keratoplasty due to its high rate of spontaneous disruption.
• The combined suturing technique's ability to maintain low astigmatism is contingent upon suture integrity.
• Long-term follow-up studies are essential to determine the true clinical value of keratoplasty suturing techniques.