Küçükerdönmez C, Akova Y A, Dursun D
Department of Ophthalmology, Başkent University School of Medicine, Ankara, Turkey.
Eur J Ophthalmol. 2004 Mar-Apr;14(2):94-9. doi: 10.1177/112067210401400202.
To evaluate the effectiveness of single running suture adjustment in reducing postoperative astigmatism and improving visual acuity in patients who have undergone penetrating keratoplasty.
Eighteen eyes of 18 patients who underwent penetrating keratoplasty at the Department of Ophthalmology, Başkent University between May 1997 and December 2000 and who had an astigmatism over 2 diopters (D) at the fourth postoperative week were included. All eyes underwent suture adjustment at the fourth week and eight eyes with residual astigmatism above 3 D underwent a second adjustment at the eighth week. Final astigmatism and visual acuity findings were evaluated 28 weeks postoperatively.
The mean postoperative keratometric and refractive astigmatism were 5.76 +/- 0.88 D (range=4.50-7.76) and 5.22 +/- 0.78 D (range=4.0-7.0) at the fourth week, which were decreased to 2.82 +/- 0.99 D (range=1.25-4.62, p=0.0001) and 2.61 +/- 1.01 D (range= 1.0-4.5, p=0.0001) after suture adjustment, respectively. In eight eyes at the eighth week, a second suture adjustment reduced the average keratometric and refractive astigmatism from 3.86 +/- 0.65 D (range=2.75-4.62) and 3.81 +/- 0.44 D (range=3.25-4.50) to 2.33 +/- 0.91 D (range=0.87-3.50, p=0.012) and 2.06 +/- 0.68 D (range=1.0-2.75, p=0.011), respectively. At the 28th week, the average keratometric and refractive astigmatism levels for the entire cohort, which were 2.39 +/- 1.06 D (range=1.0-3.50) and 2.25 +/- 0.96 D (range=1.0-3.25), respectively, showed a statistically significant decrease when compared with the levels before the first suture adjustment (p=0.0001 for both data). The mean best-corrected visual acuity was 20/25 on the Snellen chart at the 28th week.
Postoperative adjustment of single running suture is a safe and effective way of reducing postkeratoplasty astigmatism.
评估单连续缝线调整在降低穿透性角膜移植术后患者的术后散光及提高视力方面的有效性。
纳入1997年5月至2000年12月在巴什肯特大学眼科接受穿透性角膜移植术、术后第4周散光超过2屈光度（D）的18例患者的18只眼。所有眼睛在第4周进行缝线调整，8只残余散光高于3D的眼睛在第8周进行二次调整。术后28周评估最终散光和视力结果。
术后第4周平均角膜曲率散光和屈光性散光分别为5.76±0.88D（范围=4.50 - 7.76）和5.22±0.78D（范围=4.0 - 7.0），缝线调整后分别降至2.82±0.99D（范围=1.25 - 4.62，p = 0.0001）和2.61±1.01D（范围=1.0 - 4.5，p = 0.0001）。在第8周的8只眼中，二次缝线调整使平均角膜曲率散光和屈光性散光分别从3.86±0.65D（范围=2.75 - 4.62）和3.81±0.44D（范围=3.25 - 4.50）降至2.33±0.91D（范围=0.87 - 3.50，p = 0.012）和2.06±0.68D（范围=1.0 - 2.75，p = 0.011）。在第28周，整个队列的平均角膜曲率散光和屈光性散光水平分别为2.39±1.06D（范围=1.0 - 3.50）和2.25±0.96D（范围=1.0 - 3.25），与首次缝线调整前的水平相比，差异有统计学意义（两组数据p均 = 0.0001）。第28周时，Snellen视力表上的平均最佳矫正视力为20/25。
单连续缝线的术后调整是降低角膜移植术后散光的一种安全有效的方法。
