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Results of Penetrating Keratoplasty Using a Double Running Suture Technique

Results of Penetrating Keratoplasty Using a Double Running Suture Technique Abstract • The results of 84 consecutive penetrating keratoplasties in which a double running suture technique was used are presented herein. The second suture was smaller, looser, and more superficial than the first, causing less corneal distortion, thus allowing better visual acuity. The two sutures were removed at two and 12 months after transplantation. The visual acuities attained were almost as good at three months as at 13 months, and the graft curvature did not change notably from three to 12 months after keratoplasty. There were only two instances of postoperative wound dehiscence (2.4%). Thus, the double running suture technique allowed early visual rehabilitation without increasing the risk of corneal dehiscence from early suture removal. References 1. Brown SI, Tragakis MP: Wound dehiscence with keratoplasty: Complication of the continuous-suture technique . Am J Ophthalmol 1971;72:115-116. 2. Newell FW, Dixon JM: Effect of subconjunctival cortisone upon the immediate union of experimental corneal grafts . Am J Ophthalmol 1951;34:977-982. 3. Palmerton ES: The effect of local cortisone on wound healing in rabbit corneas . Am J Ophthalmol 1955;40:344-353. 4. Aquavella J, Gasset AR, Dohlman CH: Corticosteroids in corneal wound healing . Am J Ophthalmol 1964;58:621-626. 5. Gasset AR, Lorenzetti DWC, Ellison EM, et al: Quantitative corticosteroid effect on corneal wound healing . Arch Ophthalmol 1969;81:589-591.Crossref 6. McDonald TO, Borgmann AR, Roberts MD, et al: Corneal wound healing: I. Inhibition of stromal healing by three dexamethasone derivatives . Invest Ophthalmol Vis Sci 1970;9:703-709. 7. Sugar J, Chandler JW: Experimental corneal wound strength: Effect of topically applied corticosteroids . Arch Ophthalmol 1974;92:248-249.Crossref 8. Richard JM, Paton D, Gasset AR: A comparison of penetrating keratoplasty and lamellar keratoplasty in the surgical management of keratoconus . Am J Ophthalmol 1978;86:807-811. 9. McNeill JI, Kaufman HE: A double running suture technique for keratoplasty: Earlier visual rehabilitation . Ophthalmic Surg 1977;8:58-61. 10. Bourne WM: Examination and photography of donor corneal endothelium . Arch Ophthalmol 1976;94:1799-1800.Crossref 11. McCarey BE, Kaufman HE: Improved corneal storage . Invest Ophthalmol Vis Sci 1974;13:165-173. 12. Bourne WM: A corneal trephine press . Trans Am Acad Ophthalmol Otolaryngol 1973;78:51-52. 13. Mishima S, Hedbys BO: Measurement of corneal thickness with the Haag-Streit pachometer . Arch Ophthalmol 1968;80:710-713.Crossref 14. Eve FR, Troutman RC: Placement of sutures used in corneal incisions . Am J Ophthalmol 1976;82:786-789. 15. Fine M: Therapeutic keratoplasty in Fuchs' dystrophy . Am J Ophthalmol 1964;57:371-378. 16. Anseth A: Keratoplasty for keratoconus: A report of 50 operated eyes . Acta Ophthalmol 1967;45:684-687.Crossref 17. Brown SI: Results of corneal transplantation in diffuse corneal edema . Am J Ophthalmol 1970;70:20-23. 18. Paton D: Results of penetrating keratoplasty with microsurgical technique: A review of 40 consecutive cases . Int Ophthalmol Clin 1970;10:347-377.Crossref 19. Moore TE, Aronson SB: The corneal graft: A multiple variable analysis of the penetrating keratoplasty . Am J Ophthalmol 1971;72:205-296. 20. Keates RH, Falkenstein S: Keratoplasty in keratoconus . Am J Ophthalmol 1972;74:442-444. 21. Stark WJ, Paton D, Maumenee AE, et al: The results of 102 penetrating keratoplasties using 10-0 monofilament and nylon suture . Ophthalmic Surg 1972;3:11-25. 22. Troutman RC, Meltzer M: Astigmatism and myopia in keratoconus . Trans Ant Ophthalmol Soc 1972;70:265-277. 23. Boruchoff SA, Jensen AD, Dohlman CH: Comparison of suturing techniques in keratoplasty for keratoconus . Ann Ophthalmol 1975;7:433-436. 24. Arentsen JJ, Laibson PR: Penetrating keratoplasty and cataract extraction: Combined vs nonsimultaneous surgery . Arch Ophthalmol 1978;96:75-76.Crossref 25. Farge EJ: Results of penetrating keratoplasty over a four-year period . Ophthalmology 1978;85:650-654.Crossref 26. McNeill JI, Kaufman HE: Early visual rehabilitation after keratoplasty: A double running suture technique . Ann Ophthalmol 1978;10:652-655. 27. Moore TE Jr, Aronson SB: Results of penetrating keratoplasty in keratoconus . Adv Ophthalmol 1978;37:106-108. 28. Donshik PC, Cavanagh HD, Boruchoff SA, et al: Effect of bilateral and unilateral grafts on the incidence of rejections in keratoconus . Am J Ophthalmol 1979;87:823-826. 29. Foulks GN, Perry HD, Dohlman CH: Oversize corneal donor grafts in penetrating keratoplasty . Ophthalmology 1979;86:490-494.Crossref 30. Olson RJ, Waltman SR, Mattingly TP, et al: Visual results after penetrating keratoplasty for aphakic bullous keratopathy and Fuchs' dystrophy . Am J Ophthalmol 1979;88:1000-1004. 31. Mackman G, Brighbill FS: Combined penetrating keratoplasty and mechanical anterior vitrectomy . Ophthalmic Surg 1980;11:330-332. 32. Jensen AD, Maumenee AE: Refractive errors following keratoplasty . Trans Am Ophthalmol Soc 1974;72:123-131. 33. Schwobel W: Postoperative astigmatism after penetrating corneal grafts . Albrecht Von Graefes Arch Klin Exp Ophthalmol 1975;196:61-69.Crossref 34. Olson RJ, Mattingly TP, Waltman SR, et al: Refractive variation and donor tissue size in aphakic keratoplasty: A prospective randomized study . Arch Ophthalmol 1979;97:1480-1481.Crossref 35. Binder PS, Abel R Jr, Polack FM, et al: Keratoplasty wound separations . Am J Ophthalmol 1975;80:109-115. 36. Bigar F, Kaufman HE, McCarey BE, et al: Improved corneal storage for penetrating keratoplasties in man . Am J Ophthalmol 1975;79:115-120. 37. Stark WJ, Maumenee AE, Kenyon KR: Intermediate-term corneal storage for penetraling keratoplasty . Am J Ophthalmol 1975;79:795-802. 38. Aquavella JV, Van Horn DL, Haggerty CJ: Corneal preservation using M-K medium . Am J Ophthalmol 1975;80:791-799. 39. Waltman SR, Palmberg PF: Human penetrating keratoplasty using modified M-K medium . Ophthalmic Surg 1978;9:48-50. 40. Mascarella K, Cavanagh HD: Penetrating keratoplasty using McCarey-Kaufman preserved corneal tissue . South Med J 1979;72:1268-1271.Crossref 41. Olson RJ, Kaufman HE: Intraocular pressure and corneal thickness after penetrating keratoplasty . Am J Ophthalmol 1978;86:97-100. 42. Irvine AR, Capella JA, Kaufman HE: Corneal thickness: Postoperative changes in refrigerated and cryopreserved corneal grafts . Arch Ophthalmol 1969;82:232-238.Crossref 43. Ginsberg SP, Capella JA, Kaufman HE: Normal patterns of corneal thinning after penetrating keratoplasty using refrigerated and cryopreserved donor material . Am J Ophthalmol 1972;73:555-559. 44. Kimura C, Tanishima T: Thickness of the corneal graft after penetrating keratoplasty . Jpn J Ophthalmol 1975;19:348-353. 45. Bourne WM, O'Fallon WM: Endothelial cell loss during penetrating keratoplasty . Am J Ophthalmol 1978;85:760-766. 46. West CE, Fitzgerald CR, Sewell JH: Cystoid macular edema following aphakic keratoplasty . Am J Ophthalmol 1973;75:77-81. 47. Fine M: Problems of keratoplasty in aphakic eye , in Bellows JG (ed): Contemporary Ophthalmology Honoring Sir Stewart Duke-Elder . Baltimore, Williams & Wilkins Co, 1972, pp 138-143. 48. Forstot SL, Binder PS, Fitzgerald C, et al: The incidence of retinal detachment after penetrating keratoplasty . Am J Ophthalmol 1975;80:102-105. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Results of Penetrating Keratoplasty Using a Double Running Suture Technique

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Publisher
American Medical Association
Copyright
Copyright © 1981 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1981.03930020465012
Publisher site
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Abstract

Abstract • The results of 84 consecutive penetrating keratoplasties in which a double running suture technique was used are presented herein. The second suture was smaller, looser, and more superficial than the first, causing less corneal distortion, thus allowing better visual acuity. The two sutures were removed at two and 12 months after transplantation. The visual acuities attained were almost as good at three months as at 13 months, and the graft curvature did not change notably from three to 12 months after keratoplasty. There were only two instances of postoperative wound dehiscence (2.4%). Thus, the double running suture technique allowed early visual rehabilitation without increasing the risk of corneal dehiscence from early suture removal. References 1. Brown SI, Tragakis MP: Wound dehiscence with keratoplasty: Complication of the continuous-suture technique . Am J Ophthalmol 1971;72:115-116. 2. Newell FW, Dixon JM: Effect of subconjunctival cortisone upon the immediate union of experimental corneal grafts . Am J Ophthalmol 1951;34:977-982. 3. Palmerton ES: The effect of local cortisone on wound healing in rabbit corneas . Am J Ophthalmol 1955;40:344-353. 4. Aquavella J, Gasset AR, Dohlman CH: Corticosteroids in corneal wound healing . Am J Ophthalmol 1964;58:621-626. 5. Gasset AR, Lorenzetti DWC, Ellison EM, et al: Quantitative corticosteroid effect on corneal wound healing . Arch Ophthalmol 1969;81:589-591.Crossref 6. McDonald TO, Borgmann AR, Roberts MD, et al: Corneal wound healing: I. Inhibition of stromal healing by three dexamethasone derivatives . Invest Ophthalmol Vis Sci 1970;9:703-709. 7. Sugar J, Chandler JW: Experimental corneal wound strength: Effect of topically applied corticosteroids . Arch Ophthalmol 1974;92:248-249.Crossref 8. Richard JM, Paton D, Gasset AR: A comparison of penetrating keratoplasty and lamellar keratoplasty in the surgical management of keratoconus . Am J Ophthalmol 1978;86:807-811. 9. McNeill JI, Kaufman HE: A double running suture technique for keratoplasty: Earlier visual rehabilitation . Ophthalmic Surg 1977;8:58-61. 10. Bourne WM: Examination and photography of donor corneal endothelium . Arch Ophthalmol 1976;94:1799-1800.Crossref 11. McCarey BE, Kaufman HE: Improved corneal storage . Invest Ophthalmol Vis Sci 1974;13:165-173. 12. Bourne WM: A corneal trephine press . Trans Am Acad Ophthalmol Otolaryngol 1973;78:51-52. 13. Mishima S, Hedbys BO: Measurement of corneal thickness with the Haag-Streit pachometer . Arch Ophthalmol 1968;80:710-713.Crossref 14. Eve FR, Troutman RC: Placement of sutures used in corneal incisions . Am J Ophthalmol 1976;82:786-789. 15. Fine M: Therapeutic keratoplasty in Fuchs' dystrophy . Am J Ophthalmol 1964;57:371-378. 16. Anseth A: Keratoplasty for keratoconus: A report of 50 operated eyes . Acta Ophthalmol 1967;45:684-687.Crossref 17. Brown SI: Results of corneal transplantation in diffuse corneal edema . Am J Ophthalmol 1970;70:20-23. 18. Paton D: Results of penetrating keratoplasty with microsurgical technique: A review of 40 consecutive cases . Int Ophthalmol Clin 1970;10:347-377.Crossref 19. Moore TE, Aronson SB: The corneal graft: A multiple variable analysis of the penetrating keratoplasty . Am J Ophthalmol 1971;72:205-296. 20. Keates RH, Falkenstein S: Keratoplasty in keratoconus . Am J Ophthalmol 1972;74:442-444. 21. Stark WJ, Paton D, Maumenee AE, et al: The results of 102 penetrating keratoplasties using 10-0 monofilament and nylon suture . Ophthalmic Surg 1972;3:11-25. 22. Troutman RC, Meltzer M: Astigmatism and myopia in keratoconus . Trans Ant Ophthalmol Soc 1972;70:265-277. 23. Boruchoff SA, Jensen AD, Dohlman CH: Comparison of suturing techniques in keratoplasty for keratoconus . Ann Ophthalmol 1975;7:433-436. 24. Arentsen JJ, Laibson PR: Penetrating keratoplasty and cataract extraction: Combined vs nonsimultaneous surgery . Arch Ophthalmol 1978;96:75-76.Crossref 25. Farge EJ: Results of penetrating keratoplasty over a four-year period . Ophthalmology 1978;85:650-654.Crossref 26. McNeill JI, Kaufman HE: Early visual rehabilitation after keratoplasty: A double running suture technique . Ann Ophthalmol 1978;10:652-655. 27. Moore TE Jr, Aronson SB: Results of penetrating keratoplasty in keratoconus . Adv Ophthalmol 1978;37:106-108. 28. Donshik PC, Cavanagh HD, Boruchoff SA, et al: Effect of bilateral and unilateral grafts on the incidence of rejections in keratoconus . Am J Ophthalmol 1979;87:823-826. 29. Foulks GN, Perry HD, Dohlman CH: Oversize corneal donor grafts in penetrating keratoplasty . Ophthalmology 1979;86:490-494.Crossref 30. Olson RJ, Waltman SR, Mattingly TP, et al: Visual results after penetrating keratoplasty for aphakic bullous keratopathy and Fuchs' dystrophy . Am J Ophthalmol 1979;88:1000-1004. 31. Mackman G, Brighbill FS: Combined penetrating keratoplasty and mechanical anterior vitrectomy . Ophthalmic Surg 1980;11:330-332. 32. Jensen AD, Maumenee AE: Refractive errors following keratoplasty . Trans Am Ophthalmol Soc 1974;72:123-131. 33. Schwobel W: Postoperative astigmatism after penetrating corneal grafts . Albrecht Von Graefes Arch Klin Exp Ophthalmol 1975;196:61-69.Crossref 34. Olson RJ, Mattingly TP, Waltman SR, et al: Refractive variation and donor tissue size in aphakic keratoplasty: A prospective randomized study . Arch Ophthalmol 1979;97:1480-1481.Crossref 35. Binder PS, Abel R Jr, Polack FM, et al: Keratoplasty wound separations . Am J Ophthalmol 1975;80:109-115. 36. Bigar F, Kaufman HE, McCarey BE, et al: Improved corneal storage for penetrating keratoplasties in man . Am J Ophthalmol 1975;79:115-120. 37. Stark WJ, Maumenee AE, Kenyon KR: Intermediate-term corneal storage for penetraling keratoplasty . Am J Ophthalmol 1975;79:795-802. 38. Aquavella JV, Van Horn DL, Haggerty CJ: Corneal preservation using M-K medium . Am J Ophthalmol 1975;80:791-799. 39. Waltman SR, Palmberg PF: Human penetrating keratoplasty using modified M-K medium . Ophthalmic Surg 1978;9:48-50. 40. Mascarella K, Cavanagh HD: Penetrating keratoplasty using McCarey-Kaufman preserved corneal tissue . South Med J 1979;72:1268-1271.Crossref 41. Olson RJ, Kaufman HE: Intraocular pressure and corneal thickness after penetrating keratoplasty . Am J Ophthalmol 1978;86:97-100. 42. Irvine AR, Capella JA, Kaufman HE: Corneal thickness: Postoperative changes in refrigerated and cryopreserved corneal grafts . Arch Ophthalmol 1969;82:232-238.Crossref 43. Ginsberg SP, Capella JA, Kaufman HE: Normal patterns of corneal thinning after penetrating keratoplasty using refrigerated and cryopreserved donor material . Am J Ophthalmol 1972;73:555-559. 44. Kimura C, Tanishima T: Thickness of the corneal graft after penetrating keratoplasty . Jpn J Ophthalmol 1975;19:348-353. 45. Bourne WM, O'Fallon WM: Endothelial cell loss during penetrating keratoplasty . Am J Ophthalmol 1978;85:760-766. 46. West CE, Fitzgerald CR, Sewell JH: Cystoid macular edema following aphakic keratoplasty . Am J Ophthalmol 1973;75:77-81. 47. Fine M: Problems of keratoplasty in aphakic eye , in Bellows JG (ed): Contemporary Ophthalmology Honoring Sir Stewart Duke-Elder . Baltimore, Williams & Wilkins Co, 1972, pp 138-143. 48. Forstot SL, Binder PS, Fitzgerald C, et al: The incidence of retinal detachment after penetrating keratoplasty . Am J Ophthalmol 1975;80:102-105.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Sep 1, 1981

References

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