Introduction: The aim of this study was to determine the effect of selective suture removal on post-penetrating keratoplasty (PK) refraction and keratometry in patients operated with 16 interrupted 10.0 nylon sutures.
Methods: The study group consisted of 48 consecutive penetrating keratoplasties operated between January 2021 and January 2023 at Baskent University Faculty of Medicine, Department of Ophthalmology. Selective suture removal started 2 months after PK. In each visit one or two sutures were removed under guidance of corneal topography. The meridian of the suture and the number of sutures to be removed were determined according to the patient’s refraction and topography, by an experienced ophthalmologist, with an attempt to decrease astigmatism. Best corrected visual acuity (BCVA), manifest refraction and keratometry were recorded at the postoperative 2nd, 6th, and 12th months.
Results: At the second month, before suture removal, the average spherical equivalent of refraction was -0.160±3.59 diopters; it was -0.84±4.21 diopters at the 6th month and -1.58±2.66 diopters at the completion of suture removal at 1 year. Refractive and keratometric astigmatism were 4.02±2.14 and 4.65±2.25 at the 2nd month and 2.81±1.82 and 3.19± 2.94 diopters, respectively at the 12th month. A BCVA of 20/50 or better was achieved in 59% of patients.
Conclusions: Early selective suture removal in PK patients operated with interrupted 10-0 nylon sutures is associated with a favorable keratometric and refractive outcome. A decrease of at least one diopter of keratometric and refractive astigmatism can be achieved when compared to pre-suture removal values.