Full- versus partial-thickness sutures: experimental models of corneal injury repair
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ORIGINAL PAPER
Full- versus partial-thickness sutures: experimental models of corneal injury repair Jose´ Dalma-Weiszhausz . Mauricio Galva´n-Cha´vez . Ethel Beatriz Guinto-Arcos . Daniel Yoshiro Miyake-Martı´nez . Abelardo Rodrı´guez-Reyes . ´ vila . Maria F. Golzarri . Christian Sebastia´n-Arellano . Ned Merari Da´vila-A Carlos Eduardo Rı´os-Elizondo
Received: 3 April 2020 / Accepted: 29 August 2020 Ó Springer Nature B.V. 2020
Abstract Purpose To evaluate the performance of full-thickness (FT) versus partial-thickness (PT) sutures in a full-thickness corneal wound in an animal model. Methods This is a prospective, experimental, comparative, longitudinal study. A 6-mm linear, fullthickness corneal incision was performed on the right eye of eight domestic pigs. Eyes were randomly assigned for repair with interrupted PT (80–90% depth) sutures or FT 10-0 nylon sutures. Anterior segment OCT, corneal pachymetry and clinical photographs were obtained 1, 4 and 8 weeks postoperatively. Corneal thickness, depth of suture placement, perilesional edema, coaptation of wound edges and complications were noted. Histopathologic examination was performed at 8 weeks. Results 100% of the eyes with FT sutures developed a linear, less opaque scar. 100% of the eyes with PT developed a dense, opaque stromal scar (p = 0.02). Vascularization of the cornea was present in 75% of PT group and 25% in the FT group (p = 0.50). As the
J. Dalma-Weiszhausz (&) M. Galva´n-Cha´vez E. B. Guinto-Arcos D. Y. Miyake-Martı´nez A. Rodrı´guez-Reyes M. F. Golzarri ´ vila C. Sebastia´n-Arellano N. M. Da´vila-A C. E. Rı´os-Elizondo Retina Service, Asociacio´n Para Evitar la Ceguera en Me´xico, Hospital ‘‘Dr. Luis Sa´nchez Bulnes’’, Vicente Garcı´a Torres 46, San Lucas, Coyoacan, C.P. 04030 Mexico City, Mexico e-mail: [email protected]
corneas healed, there was a marked trend toward thicker corneas in the PT group versus FT group with a median difference of - 63 lm at week 1 [median 788 lm vs. 725 lm, (p = 0.11)], - 38 lm at week 4, (724 lm vs. 686 lm, (p = 0.63)) and - 47 lm median difference at week 8 with (670 lm vs. 623 lm, (p = 0.06)). Histopathology showed disorganization of the collagen fibers and the formation of a retrocorneal fibrous membrane in the PT group. Conclusions The FT group presented less corneal edema at week 8 with a more linear and less opaque scar. Histopathology showed a better-organized scar and endothelialization without the formation of a fibrous membrane. Keywords Corneal wound Corneal laceration Corneal trauma Wound repair Corneal suture
Introduction Corneal trauma is an important cause of ocular morbidity and visual impairment with potentially devastating consequences even with prompt intervention by expert hands. Full-thickness corneal wounds represent between 10 and 14% of the total traumatic ocular injuries that present to the emergency service and may comprise up to 66% of all corneal perforations [1]. They are more frequent in males between the
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