Reduction of AstigmatismafterPerforating Keratoplasty by Adjustementof SingleRunning Suture and its Influence on Visual Acuity

Overview

The authors assess the outcomes of postkeratoplasty single running suture adjustmentin 14 eyes (16 adjustments) of 14 patients (4 women, 10 men). The averageage of patients was 39.68 year (ranging from 19 to 70 years). The suture adjustmentwasdonein time span2 to 39weeks followingafter perforatingkeratoplasty (PKP),average 7.5 weeks. Follow up time was from 1 to 12 months, average 10.8 months.The value of keratometric and topographic astigmatism before suture adjustmentwere compared to the value of keratometric and topographic astigmatism 1, 6 and12 months after suture adjustment. The changes of corneal refractive power andchanges of uncorrected and best-corrected visual acuity were noticed aswell. Themean value of keratometric astigmatism 7.47 ± 2.69 D and mean topographic astigmatism 7.75 ± 3.25 D before suture adjustment was decreased to 4.92 ± 2.41 Dand 4.83 ± 1.46Drespectively onemonthafter suture adjustment.These reductionsof keratometric and topographic astigmatism (2.55Dand 2.92Drespectively) werestatistically significant (p = 0.0416, and p = 0.0211 respectively). The mean keratometricastigmatism was still significantly lower (p < 0.05) after 6 and 12 monthsafter suture adjustment in comparison to status before suture adjustment. Inassessment of topographic changes we noticed small continuous increasing ofastigmatism (1.27 D after 6 months and 0.2 D after 12 months after suture adjustment).These changes of topographic astigmatism were not statistically significant.The changes of mean corneal refractive power were not statisticallysignificant as well. The mean uncorrected visual acuity increased significantly(from 0.13 to 0.34, p < 0.05) 1 month after suture adjustment. This improvement ofuncorrected visual acuity was not significant after 6 and 12 months after sutureadjustment. The best-corrected visual acuity improved from 0.37 to 0.61 after onemonth after suture adjustment but was not statistically significant and stayed stillat the same level with minimal changes during follow up time.

Key words:
perforating keratoplasty, astigmatism, single running suture adjustment,visual acuity