COMPARISON OF SUTURE-IN AND SUTURE-OUT POSTKERATOPLASTY ASTIGMATISM WITH SINGLE RUNNING SUTURE OR COMBINED RUNNING AND INTERRUPTED SUTURES

PURPOSE: To evaluate postkeratoplasty astigmatism between two suture t echniques 2 to 4 years postoperatively in a group of patients previous ly studied 9 months postoperatively. METHODS: Thirty-two patients who underwent penetrating keratoplasty were randomly assigned to; one of t wo groups. Group 1 (16 patients) had a 24-bite single running 10-0 nyl on suture with postoperative suture tension adjustment; group 2 (16 pa tients) had combined 16-bite running and eight interrupted 10-0 nylon sutures with selective postoperative removal of interrupted sutures. D uring long-term follow-up, the running suture was removed in 19 patien ts (59%). RESULTS: Postoperative astigmatism was slightly lower in pat ients with the single running suture technique when sutures were in pl ace and was slightly greater after the sutures were removed compared w ith the combined running and interrupted suture technique (sutures in: single running suture +/- SD, 2.6 +/- 1.2 diopters [five patients, 31 %]; combined running and interrupted sutures, 3.8 +/- 1.1 diopters [ei ght patients, 50%]; sutures out: single running suture, 3.3 +/- 1.3 di opters [11 patients, 69%]; combined running and interrupted sutures, 2 .8 +/- 1.5 diopters [eight patients, 50%]). These differences were not statistically significant (sutures in, P <.13; sutures out, P <.46). Averages of follow-up were group 1, 48.3 +/- 10.6 months and group 2, 46.3 +/- 13.0 months. Follow-up ranged from 23 to 60 months. CONCLUSIO NS: Postoperative astigmatism 4 years after penetrating keratoplasty i s similar for these two suturing techniques, with or without residual sutures. A single running suture results in more rapid visual rehabili tation and less early astigmatism compared with the combined interrupt ed and running suture technique.