REFRACTIVE AND KERATOMETRIC RESULTS AFTER THE TRIPLE PROCEDURE - EXPERIENCE WITH EARLY AND LATE SUTURE REMOVAL

Objective: The objective of this study was to determine the outcome of early and late suture removal after the triple procedure (i.e., penet rating keratoplasty, cataract extraction, lens implant). Design and Pa rticipants: The refractive and keratometric results of 106 eyes underg oing the triple procedure were reviewed. The target postoperative refr active error was -1 diopter (D). Results: Average length of follow-up was 40.3 months, Twenty eyes had sutures removed early (<18 months aft er surgery), 39 had sutures removed late (greater than or equal to 18 months after surgery), and 47 had sutures still intact al last followu p. A best spectacle-corrected visual acuity of 20/40 or better was ach ieved in 90% of eyes with sutures removed early, 82.1% with sutures re moved late, and 70.2% with sutures in place. For all eyes, the mean sp herical equivalent at last follow-up was -2.50 D, with 75% of eyes fal ling between -4 and +2 D. The mean final refractive error was -3.40 +/ - 3.53 D for eyes with sutures removed early and -1.79 +/- 3.99 D for eyes with sutures removed late. Eyes with sutures remaining had a mean final refractive error of -0.33 +/- 2.25 D. There was an overall decr ease in refractive and keratometric astigmatism after both early and l ate suture removal with no significant difference between groups. Howe ver, there was a wide range of change with some eyes experiencing a de crease and others an increase in astigmatism. Mean postoperative K rea dings increased significantly for both groups after suture removal (fi nal mean K, 47.00 D) but remained stable for eyes with sutures in. Con clusion: The authors data suggest that ?he final refractive error and net change in refractive and keratometric astigmatism after the triple procedure are not dependent on the timing of suture removal.