Suturing large therapeutic corneal grafts based on donor size: A simplified technique for the novice corneal surgeon

Purpose: We describe a simple technique for achieving radial and equally spaced sutures by novice corneal surgeon in cases of large penetrating keratoplasties. Method: A simple mathematical equation was derived for precise calculation of spacing between interrupted sutures in large grafts (n = 50). The ubiquitous and easily available Castroviejo calipers were used to mark the donor cornea according to the derived formula. Interrupted sutures were passed over the pre-marked points and tied. Radiality was assessed in the post-operative period. Results: A total of 50 eyes undergoing therapeutic keratoplasty with graft size between 9 and 12 mm were enrolled. Equally spaced and radially aligned sutures were achieved in all cases postoperatively with watertight apposition of the graft host junction using our simple technique. Conclusion: The Castroviejo caliper can be effectively used for equidistant spacing of interrupted sutures in large therapeutic grafts by a novice surgeon thereby simplifying the procedure and reducing the surgical time.