Topographic Changes After Suture Removal in Patients with Penetrating Keratoplasty

ABS TRACT Objective: To investigate the changes in topographic parameters after suture removal in patients with penetrating keratoplasty (PK) and to assess the predictability of these changes. Material and Methods: This prospective study included 88 eyes of 88 corneal graft patients. Fifty-one were male and 37 female. Mean age was 52.5±18.3 years. Main indications were keratoconus (23) and bullous keratopathy (18). Donor corneas were cut from the endothelial side with a disposable donor punch and sutured into the recipient bed with single 10-0 nylon running suture. Sutures were removed at 1 year. Corneal topographies were acquired with Keratograph (Oculus, Wetzlar, Germany) immediately before and one month after suture removal. Flattest and steepest keratometry (K) values (Diopter:D), magnitude and axis of the astigmatism, eccentricity (Ecc), Q value, analyzed area and topographic patterns were recorded. Results: Mean K value increased from 42.18±4.97 (30.65-53.20) to 44.46±4.10 (29.45-55.20) D (p=0.001). Mean astigmatism increased from 4.66 to 5.68 D (p=0.017). Ecc value decreased from 0.48 to 0.11 (p=0.000). Analyzed area increased from 36.90 to 41.44% (p= 0.012). Prolate topographic patterns decreased from 42.0% to 36.4%, oblate patterns increased from 26.1% to 39.8% after suture removal. Conclusion: Mean K value increased 2.3 D after suture removal, meaning a myopic shift in refraction. Topographic analysis can be acquired in a wider area. Overall oblate and ellipsoid geometry of the cornea, determined by the Q and Ecc values, remains the same after suture removal.

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