Nuzzi Raffaele, Burato Claudio, Tridico Federico, Nuzzi Alessia, Caselgrandi Paolo
Eye Clinic Section, Department of Surgical Sciences, University of Turin, Turin, Italy.
Department of Clinical Sciences and Community Health, Eye Clinic San Giuseppe Hospital, IRCCS Multimedica, University of Milan, Milan, Italy.
Clin Ophthalmol. 2022 Mar 15;16:797-802. doi: 10.2147/OPTH.S355538. eCollection 2022.
The purpose of this prospective study is to evaluate the effects of different suturing techniques in perforating keratoplasty surgery, in order to identify the most effective in reducing post-operative astigmatism.
We analysed data from patients who underwent penetrating keratoplasty for different indications. All interventions were performed by the same surgeon. Patients were subjected to a follow-up of at least 12 months after surgery, during which astigmatism (assessed by keratometry, topography and refraction) best-corrected visual acuity (BCVA) and complications were evaluated. A total of 100 eyes from 100 patients were included and were randomly assigned to five different groups, each one featuring a different suturing technique: interrupted (INT), single running (SRS), double running with two 10-0 sutures (DRS), double running antitorque with two 10-0 sutures (DRSa), double running with both 10-0 and 11-0 sutures (DRS with 11-0).
There is a statistically significant difference in astigmatism after surgery between the double running sutures groups and the others with different techniques. However, there is no statistically significant difference between the INT and the SRS group; moreover, there is no statistically significant difference between the different groups with double running sutures (DRS, DRSa, DRS with 11-0). There is no statistically significant difference in BCVA values among the five groups. The wound leak rate was 10% in the INT group, 5.3% in the SRS group and 0% in all groups with double running sutures.
In penetrating keratoplasty surgery, the double running suture technique reduces postoperative astigmatism, provides faster visual rehabilitation and features lower complication rates when compared to techniques featuring single running and interrupted sutures. No significant difference in terms of postoperative astigmatism or complication rates was observed among patients receiving double running suture techniques.
本前瞻性研究的目的是评估不同缝合技术在穿透性角膜移植手术中的效果，以确定哪种技术在减少术后散光方面最有效。
我们分析了因不同适应证接受穿透性角膜移植手术患者的数据。所有干预均由同一位外科医生进行。患者术后至少随访12个月，在此期间评估散光（通过角膜曲率计、地形图和验光评估）、最佳矫正视力（BCVA）和并发症。共纳入100例患者的100只眼，并将其随机分为五组，每组采用不同的缝合技术：间断缝合（INT）、单连续缝合（SRS）、两根10-0缝线的双连续缝合（DRS）、两根10-0缝线的双连续抗扭转缝合（DRSa）、10-0和11-0缝线的双连续缝合（带11-0的DRS）。
双连续缝合组与其他不同技术组术后散光存在统计学显著差异。然而，INT组和SRS组之间无统计学显著差异；此外，不同双连续缝合组（DRS、DRSa、带11-0的DRS）之间也无统计学显著差异。五组之间的BCVA值无统计学显著差异。INT组的伤口渗漏率为10%，SRS组为5.3%，所有双连续缝合组均为0%。
在穿透性角膜移植手术中，与单连续和间断缝合技术相比，双连续缝合技术可减少术后散光，提供更快的视力恢复，且并发症发生率更低。接受双连续缝合技术的患者在术后散光或并发症发生率方面未观察到显著差异。
