Spherical equivalent (SE) outcomes after suture manipulation in post operative deep anterior lamellar keratoplasty (DALK) patients

Abstract

Introduction: Deep anterior lamellar keratoplasty (DALK) is a successful intervention among other surgical options for treating keratoconus. However after DALK surgery there are other post operative refractive morbidities which affects patient satisfaction. This study analyzes how suture manipulation in post-DALK patients affects the Spherical Equivalent (SE) outcome and whether it’s adhering to the corneal coupling concept.Objective: To determine the pre and post suture manipulations adhered to the concept of corneal coupling and the effect of timing of suture removal on the Spherical Equivalent (SE) outcome.Methodology: This retrospective study involved 40 manipulations in 18 patients who underwent DALK from 2020 to 2021 for keratoconus. All the Surgeries performed by single Consultant Eye Surgeon using big bubble (BB) technique. All grafts anchored using 16 interrupted 10/0 nylon sutures. Data was obtained from hospital and patient records. Objective and Subjective SE, Mean K readings were monitored.Conclusion: Pre and Post suture manipulations adhered to the corneal coupling and there was no statistically significant SE change. Furthermore, it was observed that delaying the removal of sutures resulted in minimal changes in the SE.