Assil K K, Zarnegar S R, Schanzlin D J
Bethesda Eye Institute, Department of Ophthalmology, St. Louis University, Missouri 63110.
Am J Ophthalmol. 1992 Jul 15;114(1):63-71. doi: 10.1016/s0002-9394(14)77414-8.
We reviewed the consecutive records of 296 patients who underwent corneal transplantation at our institution to compare visual outcome between those who underwent double continuous suture wound closure and those who underwent a combination of interrupted and continuous suture wound closure. Of 156 patients on whom one of these closure techniques was performed, 33 patients satisfied our inclusion and exclusion criteria. Visual outcome between the two groups was compared at three, six, and 12 months. We found significant differences (P less than .05) in average corneal curvature and refractive spherical equivalents (steeper and more myopic, respectively, for double continuous suture wound closure); keratoscopic astigmatism, refractive cylindrical error; and average number of postoperative visits (greater for combined interrupted and continuous suture wound). Visual acuity without correction was significantly better at three months in the group that received double continuous sutures (P = .026). We found no marked difference in best-corrected visual acuity, frequency of graft rejection, requirement for contact lens fit, ratio of refracted vs potential visual acuity, or intraocular pressure. Patients who underwent double continuous suture closure had more rapid visual rehabilitation, had steeper corneas, and less astigmatism than patients who underwent the combined technique suture closure.
我们回顾了在我院接受角膜移植的296例患者的连续记录,以比较采用双重连续缝合伤口闭合术的患者与采用间断和连续缝合相结合的伤口闭合术的患者之间的视觉结果。在接受其中一种闭合技术的156例患者中,33例患者符合我们的纳入和排除标准。在术后3个月、6个月和12个月时比较两组的视觉结果。我们发现,平均角膜曲率和等效球镜度存在显著差异(P<0.05)(双重连续缝合伤口闭合术的角膜更陡峭,近视程度更高);角膜散光、柱镜验光误差;以及术后就诊平均次数(间断和连续缝合相结合的伤口闭合术更多)。接受双重连续缝合的组在术后3个月时的未矫正视力明显更好(P = 0.026)。我们发现,最佳矫正视力、移植物排斥频率、佩戴隐形眼镜的需求、矫正视力与潜在视力的比率或眼压方面没有明显差异。与接受联合技术缝合闭合术的患者相比,接受双重连续缝合闭合术的患者视力恢复更快,角膜更陡峭,散光更小。