McNeill J I, Aaen V J
Department of Ophthalmology, Loma Linda University School of Medicine, California, USA.
Cornea. 1999 Jan;18(1):19-24.
To evaluate the long-term effect of single continuous corneal suture adjustment on reducing penetrating keratoplasty astigmatism after suture removal.
Patients were identified from the original study of single continuous penetrating keratoplasty suture adjustment to reduce corneal astigmatism who were followed for more than a year after suture removal. A matching unadjusted control group was selected in the same way from those patients in the original study undergoing penetrating keratoplasty during the 2 years before the development of suture adjustment. The corneal astigmatism was compared before adjustment (study group) or <3 months after surgery (control group), >4 months after suture adjustment, and >12 months after suture removal in both groups.
A study group of 54 patients with suture adjustment and a control group of 45 patients without suture adjustment were identified. Before suture adjustment, the study group had an average keratometric astigmatism of 6.44 diopters (standard deviation [SD] = 2.51, range = 0.38-12.25), and the control group had 6.38 diopters (SD = 3.29, range = 2.75-16.00, p = 0.536). Compared to that in the unadjusted control group, the average penetrating keratoplasty astigmatism in the suture-adjusted group was reduced by 44.6% (2.36 diopters) 4.5 months after surgery and before suture removal (p = 0.0002) and by 25.4% (1.19 diopters) at least 12 months after suture removal (p = 0.011).
Postoperative adjustment of a single continuous corneal suture significantly reduces penetrating keratoplasty astigmatism after suture removal.
评估单次连续角膜缝线调整对减少拆线后穿透性角膜移植术散光的长期效果。
从最初关于单次连续穿透性角膜移植术缝线调整以减少角膜散光的研究中选取随访超过一年的患者。从最初研究中在缝线调整出现前两年内接受穿透性角膜移植术的患者中以相同方式选取匹配的未调整对照组。比较两组在调整前（研究组）或术后<3个月（对照组）、缝线调整后>4个月以及拆线后>12个月时的角膜散光情况。
确定了54例接受缝线调整的研究组患者和45例未接受缝线调整的对照组患者。在缝线调整前，研究组平均角膜散光为6.44屈光度（标准差[SD]=2.51，范围=0.38 - 12.25），对照组为6.38屈光度（SD = 3.29，范围=2.75 - 16.00，p = 0.536）。与未调整的对照组相比，缝线调整组在术后4.5个月且拆线前平均穿透性角膜移植术散光降低了44.6%（2.36屈光度）（p = 0.0002），在拆线后至少12个月降低了25.4%（1.19屈光度）（p = 0.011）。
单次连续角膜缝线的术后调整可显著降低拆线后穿透性角膜移植术的散光。
