Intrastromal Suturing Technique Compared With Interrupted Corneal Suturing Technique, Loose Suture and Knot Exposure:...

Area of Science:

• Ophthalmology
• Surgical Innovation
• Corneal Surgery

Background:

• Corneal neovascularisation (CoNV) and immune cell infiltration are significant challenges in ocular surgery, potentially leading to graft rejection and complications.
• Standard suturing techniques can sometimes exacerbate these issues, necessitating exploration of alternative methods.

Purpose of the Study:

• To evaluate the efficacy of a novel intrastromal suturing technique in mitigating CoNV and inflammation.
• To compare this technique against standard interrupted suturing, loose sutures, and sutures with knot exposure in a rabbit model.

Main Methods:

• Fourteen New Zealand White rabbits underwent bilateral corneal suturing, with each eye assigned to one of four techniques: intrastromal, standard interrupted, loose, or knot exposure.
• Corneal neovascularisation (CoNV) was quantified using image analysis.
• Immune cell densities were assessed via in vivo confocal microscopy (IVCM).

Main Results:

• The intrastromal suturing group showed significantly reduced CoNV areas at 1 week and 1 month post-procedure compared to all other groups.
• This group also exhibited lower immune cell densities in the corneal stroma and endothelium, indicating a diminished inflammatory response.
• Loose sutures and knot exposure resulted in substantial CoNV and heightened immune cell infiltration.

Conclusions:

• Intrastromal suturing is an effective technique for limiting CoNV and immune cell infiltration in the cornea.
• This method presents a potential advantage over traditional techniques, especially those involving loose sutures or exposed knots, in reducing post-operative inflammation and complications.