Effect of selective suture removal on graft astigmatism after corneal transplantation in keratoconus
Background: Selective suture removal has been demonstrated to be effective in reducing post-keratoplasty astigmatism, while the remaining sutures are left in place. Existing studies typically focus on outcomes immediately after selective suture removal, without delving into the final suture-out kera...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2025-02-01
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| Series: | Therapeutic Advances in Ophthalmology |
| Online Access: | https://doi.org/10.1177/25158414241305498 |
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| author | Sepehr Feizi Mohammad Ali Javadi Zahra Karjou Nasim Nouri Maryam Oraeeyazdani Zahra Khorrami Hamed Esfandiari |
| author_facet | Sepehr Feizi Mohammad Ali Javadi Zahra Karjou Nasim Nouri Maryam Oraeeyazdani Zahra Khorrami Hamed Esfandiari |
| author_sort | Sepehr Feizi |
| collection | DOAJ |
| description | Background: Selective suture removal has been demonstrated to be effective in reducing post-keratoplasty astigmatism, while the remaining sutures are left in place. Existing studies typically focus on outcomes immediately after selective suture removal, without delving into the final suture-out keratometric astigmatism. Objectives: To examine the impact of selective suture removal on corneal graft astigmatism following keratoplasty in keratoconus and identify potential factors associated with the changes in graft astigmatism after suture removal. Design: Retrospective, comparative interventional case series. Methods: The study included 118 consecutive eyes of 118 cases that underwent corneal transplantation for keratoconus and had a keratometric astigmatism of ⩾4 D. One or two interrupted sutures corresponding to the steep meridian were removed per session. Patients were re-evaluated at 1 to 2-month intervals, repeating the procedure until achieving a keratometric astigmatism of <4.0 D or no interrupted sutures remained in the steep meridian. Results: The mean recipient age was 28.4 ± 8.4 years. A total of 234 selective suture removals were performed, with a mean of 2.0 ± 1.1 removals per eye. Pre-suture removal keratometric astigmatism significantly decreased from 6.3 ± 2.0 D to 3.91 ± 2.23 D after the completion of selective suture removal ( p < 0.001). This value was significantly increased to 5.45 ± 2.93 D after all suture removal ( p < 0.001). Higher pre-suture removal astigmatism and deep anterior lamellar keratoplasty were associated with a more favorable response to selective suture removal. Conclusion: Selective suture removal effectively modifies graft curvature to reduce post-keratoplasty astigmatism in keratoconus patients. However, its efficacy markedly diminishes after all sutures are removed. This procedure is particularly effective in patients with higher pre-suture removal astigmatism and those undergoing deep anterior lamellar keratoplasty. |
| format | Article |
| id | doaj-art-8a200d1203e2420cbae3e143482eed07 |
| institution | Kabale University |
| issn | 2515-8414 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Ophthalmology |
| spelling | doaj-art-8a200d1203e2420cbae3e143482eed072025-02-04T16:03:19ZengSAGE PublishingTherapeutic Advances in Ophthalmology2515-84142025-02-011710.1177/25158414241305498Effect of selective suture removal on graft astigmatism after corneal transplantation in keratoconusSepehr FeiziMohammad Ali JavadiZahra KarjouNasim NouriMaryam OraeeyazdaniZahra KhorramiHamed EsfandiariBackground: Selective suture removal has been demonstrated to be effective in reducing post-keratoplasty astigmatism, while the remaining sutures are left in place. Existing studies typically focus on outcomes immediately after selective suture removal, without delving into the final suture-out keratometric astigmatism. Objectives: To examine the impact of selective suture removal on corneal graft astigmatism following keratoplasty in keratoconus and identify potential factors associated with the changes in graft astigmatism after suture removal. Design: Retrospective, comparative interventional case series. Methods: The study included 118 consecutive eyes of 118 cases that underwent corneal transplantation for keratoconus and had a keratometric astigmatism of ⩾4 D. One or two interrupted sutures corresponding to the steep meridian were removed per session. Patients were re-evaluated at 1 to 2-month intervals, repeating the procedure until achieving a keratometric astigmatism of <4.0 D or no interrupted sutures remained in the steep meridian. Results: The mean recipient age was 28.4 ± 8.4 years. A total of 234 selective suture removals were performed, with a mean of 2.0 ± 1.1 removals per eye. Pre-suture removal keratometric astigmatism significantly decreased from 6.3 ± 2.0 D to 3.91 ± 2.23 D after the completion of selective suture removal ( p < 0.001). This value was significantly increased to 5.45 ± 2.93 D after all suture removal ( p < 0.001). Higher pre-suture removal astigmatism and deep anterior lamellar keratoplasty were associated with a more favorable response to selective suture removal. Conclusion: Selective suture removal effectively modifies graft curvature to reduce post-keratoplasty astigmatism in keratoconus patients. However, its efficacy markedly diminishes after all sutures are removed. This procedure is particularly effective in patients with higher pre-suture removal astigmatism and those undergoing deep anterior lamellar keratoplasty.https://doi.org/10.1177/25158414241305498 |
| spellingShingle | Sepehr Feizi Mohammad Ali Javadi Zahra Karjou Nasim Nouri Maryam Oraeeyazdani Zahra Khorrami Hamed Esfandiari Effect of selective suture removal on graft astigmatism after corneal transplantation in keratoconus Therapeutic Advances in Ophthalmology |
| title | Effect of selective suture removal on graft astigmatism after corneal transplantation in keratoconus |
| title_full | Effect of selective suture removal on graft astigmatism after corneal transplantation in keratoconus |
| title_fullStr | Effect of selective suture removal on graft astigmatism after corneal transplantation in keratoconus |
| title_full_unstemmed | Effect of selective suture removal on graft astigmatism after corneal transplantation in keratoconus |
| title_short | Effect of selective suture removal on graft astigmatism after corneal transplantation in keratoconus |
| title_sort | effect of selective suture removal on graft astigmatism after corneal transplantation in keratoconus |
| url | https://doi.org/10.1177/25158414241305498 |
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