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Clinical outcomes of double continuous suture in femtosecond laser-assisted lamellar keratoplasty for keratoconus

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Abstract

To assess the surgical outcomes in patients who underwent femtosecond laser-assisted lamellar keratoplasty with double continuous suture for keratoconus, 100 patients (102 eyes) with keratoconus in advanced stages undergoing femtosecond laser-assisted lamellar keratoplasty in Shandong Eye Hospital were studied. In the management of keratoconus, 50 patients (52 eyes) received double continuous suture, and 50 patients (50 eyes) underwent interrupted suture. The follow-up duration was 1 year. Best-corrected visual acuity (BCVA), corneal astigmatism, cosmetic outcomes, and surgical complications were measured as outcome indicators. The epithelium healed at 3 ± 2 days and 4 ± 2 days in the double continuous suture group and the interrupted suture groups, respectively (P > 0.05). At 6 months after surgery, the average visual acuity was 20/125 and 20/100 (P > 0.05), and the average BCVA was 20/32 and 20/40 (P > 0.05), respectively. At 1 year after surgery, the average visual acuity was 20/63 and 20/80 (P > 0.05), and the average BCVA was 20/32 and 20/25 (P > 0.05), respectively; the mean curvature was 43.24 ± 5.15 D and 43.31 ± 5.58 D (P > 0.05), the mean astigmatism was 3.21 ± 1.74 D and 5.35 ± 1.37 D (P < 0.05).The looseness of sutures were found in 2 patients and 15 patients in both groups, respectively (P < 0.05). No postoperative infection or immune rejection occurred in either group during the follow-up. Comparing with the interrupted suture, using the continuous suture in femtosecond laser-assisted lamellar keratoplasty for keratoconus markedly limited the looseness of sutures with lesser corneal astigmatism and better visual quality postoperative.

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References

  1. Feizi S, Javadi MA, Fekri Y (2016) Use of deep anterior lamellar keratoplasty (DALK) for keratoconus: indications, techniques and outcomes. Expert Rev Ophthalmol 11:347–359

    Article  CAS  Google Scholar 

  2. Pakrou N, Fung S, Selva D et al (2006) Deep lamellar keratoplasty in the treatment of keratoconus. Ophthalmologica. 220:164–169

    Article  Google Scholar 

  3. Kymes SM, Walline JJ, Zadnik K et al (2004) Quality of life in keratoconus. Am J Ophthalmol 138:527–535

    Article  Google Scholar 

  4. Javadi MA, Feizi S, Rahmani S et al (2018) Refractive stability after deep anterior lamellar keratoplasty for keratoconus. Cornea. (Jul 3). https://doi.org/10.1097/ICO.0000000000001688

  5. Kim KH, Choi SH, Ahn K et al (2011) Comparison of refractive changes after deep anterior lamellar keratoplasty and penetrating keratoplasty for keratoconus. Jpn J Ophthalmol 55:93–97

    Article  Google Scholar 

  6. Javadi MA, Feizi S, Mirbabaee F et al (2009) Relaxing incisions combined with adjustment sutures for post-deep anterior lamellar keratoplasty astigmatism in keratoconus. Cornea. 28:1130–1134

    Article  Google Scholar 

  7. Shivanna Y, Nagaraja H, Kugar T et al (2013) Femtosecond laser enabled keratoplasty for advanced keratoconus. Indian J Ophthalmol 61:469–472

    Article  Google Scholar 

  8. Yoo SH, Hurmeric V (2011) Femtosecond laser-assisted keratoplasty. Am J Ophthalmol 151:189–191

    Article  Google Scholar 

  9. Chamberlain WD, Rush SW, Mathers WD et al (2011) Comparison of femtosecond laser-assisted keratoplasty versus conventional penetrating keratoplasty. Ophthalmology. 118:486–491

    Article  Google Scholar 

  10. Li S, Wang T, Bian J et al (2016) Precisely controlled side cut in femtosecond laser-assisted deep lamellar keratoplasty for advanced keratoconus. Cornea. 35:1289–1294

    Article  Google Scholar 

  11. Filatov V, Steinert RF, Talamo JH (1993) Postkeratoplasty astigmatism with single running suture or interrupted sutures. Am J Ophthalmol 115:715–721

    Article  CAS  Google Scholar 

  12. Boruchoff SA, Jensen AD, Dohlman CH (1975) Comparison of suturing techniques in keratoplasty for keratoconus. Ann Ophthalmol 7:433–436

    CAS  PubMed  Google Scholar 

  13. Van Meter WS, Gussler JR, Soloman KD et al (1991) Postkerato-plasty astigmatism control. Single continuous suture adjustment versus selective interrupted suture removal. Ophthalmology 98:177–183

    Article  Google Scholar 

  14. Frost NA, Wu J, Lai TF et al (2006) A review of randomized con-trolled trials of penetrating keratoplasty techniques. Ophthalmology. 113:942–949

    Article  Google Scholar 

  15. Kim SJ, Wee WR, Lee JH et al (2008) The effect of different suturing techniques on astigmatism after penetrating keratoplasty. J Korean Med Sci 23:1015–1019

    Article  Google Scholar 

  16. Hoffmann F (1976) Suture technique for perforating keratoplasty. Klin Monatsbl Augenheilkd 169:584–590

    CAS  PubMed  Google Scholar 

Download references

Funding

This study was supported by the National Natural Science Foundation of China (81570821, 81870639), the Key Project of the National Natural Science Foundation of China (81530027), Taishan Scholar Program (20150215, 201812150), and the Innovation Project of Shandong Academy of Medical Sciences. The funding organization had no role in the design or conduct of this research.

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All authors contributed to the study conception and design. Material preparation and data collection were performed by Yanni Jia; the data analyses were performed by Yanni Jia, Xiaolin Qi, and Ting Zhang. The first draft of the manuscript was written by Yanni Jia and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Hua Gao.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and with the 1964 Helsinki Declaration and its later amendments or comparable ethical.

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Jia, Y., Qi, X., Zhang, T. et al. Clinical outcomes of double continuous suture in femtosecond laser-assisted lamellar keratoplasty for keratoconus. Lasers Med Sci 36, 951–956 (2021). https://doi.org/10.1007/s10103-020-03114-y

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