Biomaterial Database

Postoperative suture manipulation for control of corneal graft astigmatism. 1998

L W Hirst, and J A McCoombes, and M Reedy

Department of Surgery, University of Queensland, Princess Alexandra Hospital, Woolloongabba, Australia.

OBJECTIVE To assess the effect on post-keratoplasty astigmatism of postoperative manipulation of a single running suture. METHODS All corneal transplant patients in whom a single 10/0 nylon running suture was placed between November 1990 and April 1996 were included in a prospective study of the effect of manipulation of the suture at the earliest possible time after surgery when the keratometry became possible by virtue of the epithelial surface integrity and where this revealed astigmatism of greater than 2 D. RESULTS One hundred and ninety eyes underwent suture manipulation and were followed up. Follow up on 30 eyes was discontinued. Repeat manipulation of the running suture was the most common reason for discontinuation of follow up. The remaining patients were followed for a mean (+/- SD) 415.5+/-326.4 days. Mean astigmatism of 7.8+/-3.1 D was reduced to 1.7+/-2.0 D immediately after manipulation, but regressed to 3.0+/-1.9 D (n = 76) by 1 year. The suture was removed in 32 patients. Twenty-five eyes had post-removal astigmatism measurements. In these 25 eyes, astigmatic error appeared not to revert to premanipulation levels. The only significant complication was one broken suture at manipulation. CONCLUSIONS Early suture manipulation is effective in reducing suture in post-keratoplasty astigmatism, but some regression is seen.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D009757	Nylons	Polymers where the main polymer chain comprises recurring amide groups. These compounds are generally formed from combinations of diamines, diacids, and amino acids and yield fibers, sheeting, or extruded forms used in textiles, gels, filters, sutures, contact lenses, and other biomaterials.	Polyamides,Dermalon,Ethilon,Nylon,Polyamide,Supramid,Dermalons,Ethilons,Supramids
D011182	Postoperative Care	The period of care beginning when the patient is removed from surgery and aimed at meeting the patient's psychological and physical needs directly after surgery. (From Dictionary of Health Services Management, 2d ed)	Care, Postoperative,Postoperative Procedures,Procedures, Postoperative,Postoperative Procedure,Procedure, Postoperative
D011446	Prospective Studies	Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.	Prospective Study,Studies, Prospective,Study, Prospective
D012008	Recurrence	The return of a sign, symptom, or disease after a remission.	Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
D005260	Female		Females
D005500	Follow-Up Studies	Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.	Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001251	Astigmatism	Unequal or irregular curvature of the CORNEA (Corneal astigmatism) and/or the EYE LENS (Lenticular astigmatism) resulting in REFRACTIVE ERROR.	Corneal Astigmatism,Hyperopic Astigmatism,Lenticular Astigmatism,Mixed Astigmatism,Myopic Astigmatism,Oblique Astigmatism,Astigmatism, Corneal,Astigmatism, Hyperopic,Astigmatism, Lenticular,Astigmatism, Mixed,Astigmatism, Myopic,Astigmatism, Oblique,Hyperopic Astigmatisms,Mixed Astigmatisms,Myopic Astigmatisms,Oblique Astigmatisms