Swapna Kaipu1 , Ravikumar Reddy K2 , Srinivas Prasad Kilani3 , Chandra Sekhar G4 , Rama Mohan Pathapati5 , Madhavulu Buchineni6
BACKGROUND: Traumatic corneal injuries are the leading causes of blindness in young adults and frequently occur during occupational activities. Corneal astigmatism after post traumatic corneal wound repair is the most common complication which can halt good visual outcome. We studied whether early suture removal minimizes suture related astigmatism in posttraumatic corneal wounds. METHODS: This interventional study was conducted during 2007- 2009. All traumatic corneal injury patients attending emergency room were operated within 12 hours from time of injury by a single surgeon. Interrupted suture technique followed with 10-0 mono filament nylon was used for corneal wound repair. Patients were followed every 2weeks for a period for 3-5 months. Suture removal was done after 8-10 weeks following surgery based on changes in corneal curvature as assessed by keratometric reading selectively. RESULTS: Out of 28 patients, who underwent corneal wound repair, only 25 patients (25 eyes) came for regular follow-up. There mean age of the patients was 25±1.5 yrs. We observed an apparent increase in astigmatism with increase in length of laceration. (p=0.06). After suture removal Best corrected visual acuity increased by an average of 0.24±0.04 (p<0.0001) from 0.17±0.03 to 0.41±0.02 and an average decrease of 2.03±0.54 D of keratometric astigmatism from 3.78±0.81D to 1.75±0.62 D. (p<0.0001). One patient had wound gaping as complications of early suture removal. 6 patients developed delayed traumatic cataract as a complications of trauma. None of the patients had vascularized scar. CONCLUSION: Steep meridian estimation allows selective early suture removal after corneal wound repairs. Selective suture removal at the end of the 7 th week will reduce astigmatism significantly and gives earliest visual rehabilitation.
