Chell P B, Hope-Ross M W, Shah P, McDonnell P J
Corneal Clinic, Birmingham and Midland Eye Hospital, UK.
Eye (Lond). 1996;10 ( Pt 1):133-7. doi: 10.1038/eye.1996.24.
Penetrating keratoplasty was performed on 30 patients using a single adjustable continuous 10/0 nylon suture. Seventeen patients had astigmatism of 4.00 dioptre cylinders (DC) or more and were adjusted. The latest adjustment was at 32 weeks. Following adjustment there was a significant reduction in median post-keratoplasty astigmatism from 6.00 DC to 2.50 DC (p < 0.001). Thirteen patients, with astigmatism of 4.00 DC or less, were not adjusted. Median astigmatism for the non-adjusted group was 3.00 DC and for the entire group was 2.88 DC. Long-term refraction and suture status were monitored with time. Mean follow-up was 112 weeks (range 53-170 weeks). Over the study period the entire group showed significant 'long-term astigmatic drift' (LTAD), from 2.88 DC to 3.25 DC (median drift, 1.25 DC; range, 0.00-5.50 DC) (p < 0.001). Suture adjustment and suture removal showed no significant effect on LTAD. With suture removal between 32 and 84 weeks median LTAD was 1.50 DC. For suture removal after 84 weeks, median LTAD was also 1.50 DC, but the range of LTAD was 1.50 DC, compared with a larger range of 5.00 DC in the earlier suture removal group. The technique of single continuous adjustable sutures for penetrating keratoplasty is safe, effective in reducing astigmatism, but may need modification to further enhance long-term refractive stability.
对30例患者采用单根可调节连续10-0尼龙缝线进行穿透性角膜移植术。17例患者角膜散光达4.00屈光度圆柱镜（DC）或更高并进行了调整。最近一次调整在32周时。调整后，角膜移植术后散光中位数从6.00 DC显著降至2.50 DC（p < 0.001）。13例角膜散光4.00 DC或更低的患者未进行调整。未调整组的散光中位数为3.00 DC，整个组的散光中位数为2.88 DC。随着时间推移对长期屈光和缝线状态进行监测。平均随访112周（范围53 - 170周）。在研究期间，整个组显示出显著的“长期散光漂移”（LTAD），从2.88 DC增至3.25 DC（中位数漂移1.25 DC；范围0.00 - 5.50 DC）（p < 0.001）。缝线调整和缝线拆除对LTAD无显著影响。在32至84周之间拆除缝线时，LTAD中位数为1.50 DC。对于84周后拆除缝线的情况，LTAD中位数也为1.50 DC，但LTAD范围为1.50 DC，而早期缝线拆除组的范围为5.00 DC。穿透性角膜移植术的单根连续可调节缝线技术是安全的，在减少散光方面有效，但可能需要改进以进一步提高长期屈光稳定性。
