Strategies and Application of Compression Sutures With a Modified Technique for Rapid Resolution of Large (Grade III) Hydrops: A Prospective Interventional Study.

IF 1.9 3区 医学 Q2 OPHTHALMOLOGY Cornea Pub Date : 2025-01-01 DOI:10.1097/ICO.0000000000003496
Jessica Daza, Muralidhar Ramappa, Somasheila Murthy, Sunita Chaurasia
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Abstract

Purpose: The aim of this study was to describe the strategies and outcomes, with a modified technique, of compression sutures in large acute hydrops.

Methods: This was a prospective interventional study in 29 eyes of 28 patients who underwent compression sutures using a modified technique. The degree of resolution after surgical intervention was quantified by 3 masked observers, using the slit-lamp photographic documentation and optical coherence tomography. The degree of resolution, best-corrected visual acuity, and complications were analyzed.

Results: The mean age was 20.89 (7-46) years. Five patients had pellucid marginal degeneration (pellucid marginal corneal degeneration), 23 had keratoconus, and 1 had posttrauma hydrops. The preoperative visual acuity was hand motions in all eyes. The reduction in edema was 76% on day 1, 91.6% on 6 ± 2 days, 98.6% on 18 ± 3 days from surgical intervention. The baseline pachymetry assessed on optical coherence tomography was beyond measurement in 26 eyes. The mean pachymetry at day 1 was 704 μm (range 480-950) which reduced to 607 (range 422-850) microns at 6 ± 2 days and 518 (range 415-718) microns at 18 ± 3 days postintervention ( P < 0.0001). The mean duration between the surgery and complete suture removal was 48 (35-68) days. No suture-related complications were noted. Twenty eyes could attain good visual rehabilitation with glasses/contact lenses (vision could not be assessed in 5 eyes). Penetrating keratoplasty was performed on 1 patient.

Conclusions: Compression sutures using the modified technique was safe and effective in the rapid resolution of acute hydrops in keratoconus and pellucid marginal corneal degeneration. No complications were noted, and visual restoration with spectacles and contact lenses was satisfactory.

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采用改良技术的压迫缝合策略和应用,快速解决大面积(III 级)肾积水:前瞻性介入研究。
目的:本研究旨在描述采用改良技术对大面积急性水肿进行压迫缝合的策略和结果:这是一项前瞻性干预研究,28 名患者的 29 只眼睛接受了采用改良技术的压迫缝合术。由 3 名蒙面观察员使用裂隙灯摄影记录和光学相干断层扫描对手术干预后的分辨率进行量化。结果:平均年龄为 20.89(7-46)岁。5名患者患有透明边缘变性(pellucid marginal corneal degeneration),23名患者患有角膜炎,1名患者患有外伤后水肿。所有患者术前视力均为手部运动。水肿消退率在手术后第 1 天为 76%,6±2 天为 91.6%,18±3 天为 98.6%。光学相干断层扫描评估的基线厚度超出了 26 只眼睛的测量范围。干预后第 1 天的平均厚度为 704 微米(范围 480-950),干预后 6±2 天降至 607 微米(范围 422-850),干预后 18±3 天降至 518 微米(范围 415-718)(P < 0.0001)。从手术到完全拆线的平均时间为 48 (35-68) 天。未发现与缝合相关的并发症。20只眼睛通过佩戴眼镜/隐形眼镜获得了良好的视力康复效果(5只眼睛的视力无法评估)。1 名患者接受了穿透性角膜移植术:结论:使用改良技术进行压迫缝合可安全有效地快速解决角膜水肿和透明边缘角膜变性的急性水肿问题。没有发现并发症,佩戴眼镜和隐形眼镜后视力恢复令人满意。
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来源期刊
Cornea
Cornea 医学-眼科学
CiteScore
5.20
自引率
10.70%
发文量
354
审稿时长
3-6 weeks
期刊介绍: For corneal specialists and for all general ophthalmologists with an interest in this exciting subspecialty, Cornea brings together the latest clinical and basic research on the cornea and the anterior segment of the eye. Each volume is peer-reviewed by Cornea''s board of world-renowned experts and fully indexed in archival format. Your subscription brings you the latest developments in your field and a growing library of valuable professional references. Sponsored by The Cornea Society which was founded as the Castroviejo Cornea Society in 1975.
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