Timing of PK suture removal before phaco may not affect refractive, visual outcomes

Cornea. 2009;28(8):860-864.

There appears to be no difference in removing a double running suture placed after penetrating keratoplasty 1 month before phacoemulsification surgery compared with removing the suture during surgery.

In a pilot study of 28 patients who underwent both PK and phaco, 14 patients had the PK suture removed before phaco and 14 patients had the suture removed during the phaco procedure. The sequential surgery induced an average corneal refractive change of 1.63, -2.98 x 96° in patients in the preoperative removal group and 2.14, -2.84 x 90° in patients in the intraoperative removal group.

There were differences in corneal power vector change between the two groups. The spherical component changed a mean 0.14 in the preoperative group vs. 0.72 in the intraoperative group, and the astigmatic component changed a mean 1.49 in the preoperative group vs. 1.42 in the intraoperative group. These changes were statistically significant but not clinically relevant.

There were no significant changes postop between the two groups for spherical equivalent, index of surface variance change, and corrected and uncorrected visual acuities.

Even though the results come from a small sample size, "our findings indicate that difference in ametropia and vision between patients operated after suture removal and with simultaneous suture removal may not be clinically significant," the study authors said.