Suturing techniques and postoperative management in penetrating keratoplasty in the United Kingdom

Richard MH Lee,1 Fook Chang Lam,1 Tassos Georgiou,1 Bobby Paul,1 Kong Yong Then,1 Ioannis Mavrikakis,1 Venkata S Avadhanam,1 Christopher SC Liu1,21Sussex Eye Hospital, Brighton, United Kingdom; 2Tongdean Eye Clinic, Hove, United KingdomAims: To report on the suturing techniques and aspects of postop...

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Autores principales:	Lee RM, Lam FC, Georgiou T, Paul B, Then KY, Mavrikakis I, Avadhanam VS, Liu CS
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/68ae1fdac7c047af92e4e5b6995a6e7e
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spelling	oai:doaj.org-article:68ae1fdac7c047af92e4e5b6995a6e7e2021-12-02T00:06:24ZSuturing techniques and postoperative management in penetrating keratoplasty in the United Kingdom1177-54671177-5483https://doaj.org/article/68ae1fdac7c047af92e4e5b6995a6e7e2012-08-01T00:00:00Zhttp://www.dovepress.com/suturing-techniques-and-postoperative-management-in-penetrating-kerato-a10697https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Richard MH Lee,1 Fook Chang Lam,1 Tassos Georgiou,1 Bobby Paul,1 Kong Yong Then,1 Ioannis Mavrikakis,1 Venkata S Avadhanam,1 Christopher SC Liu1,21Sussex Eye Hospital, Brighton, United Kingdom; 2Tongdean Eye Clinic, Hove, United KingdomAims: To report on the suturing techniques and aspects of postoperative management in penetrating keratoplasty in the United Kingdom.Methods: A postal questionnaire was sent to 137 ophthalmic consultants identified from a Royal College of Ophthalmology database as having a special interest in anterior segment surgery. The questionnaire surveyed surgeon preferences for surgical and suturing technique for penetrating keratoplasty surgery, and the postoperative care of corneal grafts.Results: In all, 68% of questionnaires were completed and returned: 73% of respondents used a Flieringa ring or equivalent, 94% routinely used cardinal sutures, with 50.5% removing them at the end of the procedure. The most common suturing technique for routine penetrating keratoplasty was a single continuous suture (35%). In these cases, a 10/0 nylon suture was used by 89%. Sixty-six percent changed their technique in high-risk cases, 52% used a 3-1-1 knot, and 75% made a distinction between a reef and granny knot, with 76% using a reef. Thirty percent buried the knots within the donor material, and 29% within the host tissue. Twenty-five percent had no routine time for graft suture removal, but 41% removed them between 1 and 2 years post-surgery. After suture removal, 98% used steroids and 88% used topical antibiotics. Thirty-four percent stopped topical steroids before suture removal, with 38% stopping topical steroids more than 3 months prior to suture removal.Conclusion: This survey demonstrates that there is considerable variation in suturing techniques and postoperative care for penetrating keratoplasty. These significant variations in practice need to be considered when interpreting outcomes and research.Keywords: corneal graft, penetrating keratoplasty, anterior segment surgery, cornea, corneal surgery, corneal transplantationLee RMLam FCGeorgiou TPaul BThen KYMavrikakis IAvadhanam VSLiu CSDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2012, Iss default, Pp 1335-1340 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Lee RM Lam FC Georgiou T Paul B Then KY Mavrikakis I Avadhanam VS Liu CS Suturing techniques and postoperative management in penetrating keratoplasty in the United Kingdom
description	Richard MH Lee,1 Fook Chang Lam,1 Tassos Georgiou,1 Bobby Paul,1 Kong Yong Then,1 Ioannis Mavrikakis,1 Venkata S Avadhanam,1 Christopher SC Liu1,21Sussex Eye Hospital, Brighton, United Kingdom; 2Tongdean Eye Clinic, Hove, United KingdomAims: To report on the suturing techniques and aspects of postoperative management in penetrating keratoplasty in the United Kingdom.Methods: A postal questionnaire was sent to 137 ophthalmic consultants identified from a Royal College of Ophthalmology database as having a special interest in anterior segment surgery. The questionnaire surveyed surgeon preferences for surgical and suturing technique for penetrating keratoplasty surgery, and the postoperative care of corneal grafts.Results: In all, 68% of questionnaires were completed and returned: 73% of respondents used a Flieringa ring or equivalent, 94% routinely used cardinal sutures, with 50.5% removing them at the end of the procedure. The most common suturing technique for routine penetrating keratoplasty was a single continuous suture (35%). In these cases, a 10/0 nylon suture was used by 89%. Sixty-six percent changed their technique in high-risk cases, 52% used a 3-1-1 knot, and 75% made a distinction between a reef and granny knot, with 76% using a reef. Thirty percent buried the knots within the donor material, and 29% within the host tissue. Twenty-five percent had no routine time for graft suture removal, but 41% removed them between 1 and 2 years post-surgery. After suture removal, 98% used steroids and 88% used topical antibiotics. Thirty-four percent stopped topical steroids before suture removal, with 38% stopping topical steroids more than 3 months prior to suture removal.Conclusion: This survey demonstrates that there is considerable variation in suturing techniques and postoperative care for penetrating keratoplasty. These significant variations in practice need to be considered when interpreting outcomes and research.Keywords: corneal graft, penetrating keratoplasty, anterior segment surgery, cornea, corneal surgery, corneal transplantation
format	article
author	Lee RM Lam FC Georgiou T Paul B Then KY Mavrikakis I Avadhanam VS Liu CS
author_facet	Lee RM Lam FC Georgiou T Paul B Then KY Mavrikakis I Avadhanam VS Liu CS
author_sort	Lee RM
title	Suturing techniques and postoperative management in penetrating keratoplasty in the United Kingdom
title_short	Suturing techniques and postoperative management in penetrating keratoplasty in the United Kingdom
title_full	Suturing techniques and postoperative management in penetrating keratoplasty in the United Kingdom
title_fullStr	Suturing techniques and postoperative management in penetrating keratoplasty in the United Kingdom
title_full_unstemmed	Suturing techniques and postoperative management in penetrating keratoplasty in the United Kingdom
title_sort	suturing techniques and postoperative management in penetrating keratoplasty in the united kingdom
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/68ae1fdac7c047af92e4e5b6995a6e7e
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Suturing techniques and postoperative management in penetrating keratoplasty in the United Kingdom

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