[Postkeratoplasty astigmatism: comparison of three suturing techniques]

Area of Science:

• Ophthalmology
• Corneal Surgery
• Refractive Surgery

Background:

• Post-keratoplasty astigmatism is a common complication following corneal transplantation.
• Suturing techniques significantly influence refractive outcomes and visual acuity after penetrating keratoplasty (PK).

Purpose of the Study:

• To retrospectively analyze postkeratoplasty astigmatism and best corrected visual acuity (BCVA) after PK.
• To compare the outcomes of three different suturing techniques: single running (SR), double running (DR), and interrupted (IR) sutures.

Main Methods:

• A retrospective analysis of 150 eyes undergoing PK using SR, DR, or IR sutures.
• Evaluation of postkeratoplasty astigmatism (topographic and objective) and BCVA at 1, 4, 12, and 24 months post-surgery.
• Statistical analysis using the Kolmogorov-Smirnov test.

Main Results:

• Interrupted (IR) sutures were associated with the highest mean topographic and objective astigmatism.
• Double running (DR) sutures showed significantly lower topographic astigmatism and refractive cylinder at 4 and 12 months compared to single running (SR) sutures.
• Best corrected visual acuity (BCVA) was comparable across all three suturing groups at various time points.

Conclusions:

• The double running (DR) suturing technique appears to be superior in managing postkeratoplasty astigmatism compared to single running (SR) and interrupted (IR) techniques, particularly in the early postoperative period.
• While refractive cylinder was lower with DR sutures up to 12 months, differences in astigmatism between DR and SR groups diminished by 2 years.
• The retrospective nature and decreasing subgroup sizes over time necessitate cautious interpretation of long-term outcomes.