Selective suture removal can reduce postkeratoplasty astigmatism.

Two hundred four consecutive eyes underwent penetrating keratoplasty by a single surgeon using eight interrupted 10-0 monofilament nylon sutures in the cardinal position combined with a continuous 11-0, 16-bite monofilament nylon suture technique. The interrupted 10-0 monofilament nylon sutures were selectively removed postkeratoplasty based on central keratometry readings and corneal topography. Sutures were removed in 56 eyes in Group I as early as six to eight weeks after surgery and in 148 eyes in Group II as early as three weeks after surgery. The mean astigmatism for all groups decreased from 7.5 diopters in the first postoperative month to 2.6 diopters 14 to 16 months after surgery. Sutures were completely removed in 75 eyes in this study between 2 and 46 months after surgery without producing significant changes in corneal curvature. The complications associated with this suturing technique were no different from those associated with other suturing techniques. The selective removal of interrupted sutures postkeratoplasty can improve the recovery of vision after corneal transplantation without subjecting the eyes to increased risks.