1] Division of Ophthalmology and Visual Sciences, University of Nottingham, Nottingham, UK [2] Division of Ophthalmology and Visual Sciences, Nottingham University Hospitals, Queen's Medical Centre, Nottingham, UK.
Eye (Lond). 2013 Sep;27(9):1032-7. doi: 10.1038/eye.2013.126. Epub 2013 Jun 7.
In a previous study, we proposed that corneal topography performed 30-40 min after the initial suture removal can identify the next set of sutures requiring removal, for the treatment of post-keratoplasty astigmatism. The aim of this study was to evaluate the effect of removing subsequent sets of sutures at the same sitting.
10/0 nylon interrupted sutures were placed, to secure the graft-host junction, at the time of keratoplasty. Topography was performed using Pentacam (Oculus) before suture removal. The sutures to be removed in the steep semi-meridians were identified and removed at the slit-lamp biomicroscope. Topography was repeated 30-40 min post suture removal, the new steep semi-meridians determined, and the next set of sutures to be removed were identified and removed accordingly. Topography was repeated 4-6 weeks later and the magnitude of topographic astigmatism was recorded. A paired-samples t-test was used to evaluate the impact of selective suture removal on reducing the magnitude of topographic and refractive astigmatism.
Twenty eyes of 20 patients underwent sequential selective same-day suture removal (SSSS) after corneal transplantation. This study showed that the topographic astigmatism decreased by about 46.7% (3.68 D) and the refractive astigmatism decreased by about 37.7% (2.61 D) following SSSS. Vector calculations also show a significant reduction of both topographic and refractive astigmatism (P<0.001).
SSSS may help patients to achieve satisfactory vision more quickly and reduce the number of follow-up visits required post keratoplasty.
在之前的研究中，我们提出在初次缝线拆除后 30-40 分钟进行角膜地形图检查，可以确定需要拆除的下一组缝线，用于治疗移植术后散光。本研究旨在评估在同一次就诊时拆除后续缝线的效果。
在角膜移植时，使用 10/0 尼龙间断缝线固定移植物与宿主的交界处。缝线拆除前使用 Pentacam（Oculus）进行地形图检查。在裂隙灯生物显微镜下确定需要在陡峭半子午线处拆除的缝线并进行拆除。缝线拆除后 30-40 分钟再次进行地形图检查，确定新的陡峭半子午线，并相应地确定和拆除下一组缝线。4-6 周后再次进行地形图检查，并记录角膜散光的大小。采用配对样本 t 检验评估选择性缝线拆除对减少角膜散光和屈光性散光大小的影响。
20 例 20 只眼在角膜移植后进行了连续的选择性当日缝线拆除（SSSS）。本研究表明，SSSS 后角膜散光降低约 46.7%（3.68D），屈光性散光降低约 37.7%（2.61D）。矢量计算也显示出明显的角膜散光和屈光性散光的减少（P<0.001）。
SSSS 可能有助于患者更快地获得满意的视力，并减少角膜移植术后所需的随访次数。
