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Visual loss following suture removal postkeratoplasty
A V Spigelman1, D J Doughman, R L Lindstrom
1Department of Ophthalmology, University of Minnesota, Minneapolis 55455.
Cornea
|January 1, 1988
Summary
Suture removal after penetrating keratoplasty can lead to serious complications like endophthalmitis and expulsive hemorrhage. Surgeons can minimize risks with careful follow-up and specific preventative measures.
Area of Science:
- Ophthalmology
- Surgical Complications
- Corneal Transplantation
Background:
- Suture removal post-penetrating keratoplasty (corneal transplant) presents unpredictable surgical challenges.
- Complications can arise despite meticulous surgical technique.
Observation:
- This report details four cases of severe complications following suture removal: three cases of endophthalmitis (intraocular infection) and one case of expulsive hemorrhage (bleeding).
- These adverse events were unpredictable in nature.
Findings:
- Specific preventative measures can significantly minimize the risk of these sight-threatening complications.
- Key strategies include avoiding through-and-through sutures, prompt 24-hour post-removal follow-up for wound integrity and infection, appropriate antibiotic use, pre-operative treatment of dacryocystitis, and heightened caution in immunocompromised individuals.
Implications:
- Implementing these preventative steps is crucial for enhancing patient safety during the suture removal phase of penetrating keratoplasty.
- Minimizing these risks can improve graft survival and visual outcomes for patients undergoing corneal transplantation.