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Purse-string sutures for hyperopia following radial keratotomy
R E Damiano1, S L Forstot, C J Frank
1Corneal Consultants of Colorado, P.C., Littleton, USA.
Journal of Refractive Surgery (Thorofare, N.J. : 1995)
|August 12, 1998
Summary
Double intrastromal purse-string sutures effectively correct hyperopic shift after radial keratotomy, improving uncorrected vision and reducing refractive errors. This surgical technique offers a viable solution for patients seeking better visual outcomes post-RK.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Refractive Surgery
Background:
- Previous study presented 19 procedures using intrastromal purse-string sutures for hyperopic shift post-radial keratotomy (RK).
- This study details outcomes for 34 additional procedures with extended follow-up to assess long-term efficacy in rehabilitating eyes.
Purpose of the Study:
- To evaluate the effectiveness of double intrastromal purse-string suturing in correcting hyperopic shift and improving vision in patients with prior radial keratotomy.
- To assess the refractive outcomes and visual acuity changes following this surgical intervention.
Main Methods:
- Fifty-three eyes of 53 RK patients underwent double corneal intrastromal purse-string suturing.
- Patients were followed for at least 1 year, with pre- and post-operative refractive error and visual acuity measurements recorded.
- Included eyes had primary overcorrection or progressive hyperopic shift, with initial spherical equivalents ranging from +0.50 to +6.25 D.
Main Results:
- Average follow-up was 3.6 years (range, 1-10 years).
- Average keratometric power steepened by 2.94 D, and spherical equivalent refraction averaged -0.15 D post-suturing.
- Uncorrected visual acuity was 20/40 or better in 72% of eyes; 78% had refractive astigmatism of +/- 2.00 D or less.
- Fifteen eyes gained two or more lines of best spectacle-corrected visual acuity, with no eyes losing lines.
Conclusions:
- Double intrastromal purse-string suturing effectively steepens the central cornea.
- This procedure successfully reduces hyperopia in eyes that have undergone radial keratotomy.
- The technique provides a safe and effective method for visual rehabilitation in this patient population.