Prolene monofilament suture in Boston Keratoprosthesis surgery

Kyrillos, Ralph; Harissi‐Dagher, Mona

doi:10.5693/djo.02.2011.02.001

“…The prolene suture is chemically synthesized, monofilament, nonabsorbable, and highly histocompatible, which can maintain permanent tension strength after being implanted into the tissue and help to avoid postoperative wound infection. 33,34 Based on the characteristics of the prolene suture, about 7 to 9 suture sites were placed along the superior margin of the tarsus to reinforce the adhesion between the aponeurosis and the tarsus. The line formed by all knots was kept parallel to the upper border of the tarsus to form a smoother and more natural upper eyelid margin.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Double Eyelid Blepharoplasty and Blepharoptosis Correction With Levator Aponeurosis Plication Technique

Hao

¹

,

Cang

²

,

Cui

³

et al. 2022

Ann Plast Surg

6

0

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BackgroundFifty percent of Asians are born without a supratarsal fold (also called single eyelid), and double eyelid blepharoplasty is one of the most commonly performed and most popular facial cosmetic surgeries in the Asian population. However, patients with single eyelid frequently present with concomitant mild blepharoptosis (degree of ptosis, ≤2 mm), which often fails to cause the attention of surgeons and misses correction.MethodsA retrospective study of all patients who underwent double eyelid blepharoplasty and blepharoptosis correction simultaneously with the modified levator aponeurosis plication technique was performed from June of 2017 to June of 2020.ResultsA total of 108 patients (155 eyelids) underwent double eyelid blepharoplasty and blepharoptosis correction simultaneously with the modified levator aponeurosis plication technique and were enrolled in the study. The average follow-up period was 11.8 ± 4.5 months. There was a statistically significant difference between the preoperative margin reflex distance 1 (MRD1) and postoperative MRD1 (2.93 ± 0.37 vs 4.21 ± 0.39 mm, P = 0.000), and the mean MRD1 improvement was 1.28 ± 0.50 mm. Sufficient correction was obtained in 148 eyelids (95.5%), whereas undercorrection was observed in 5 eyelids (3.2%) and overcorrection was observed in 2 eyelids (1.3%). One hundred two patients (94.4%) were completely satisfied with the final result.All patients had smooth and elegant upper eyelid margin curve, and no patients complained of distortion of the eyelid margin contour and foreign body sensation.There were no cases of hematoma, infection, suture exposure, corneal abrasion, and keratitis in any patient.ConclusionsThis modified levator aponeurosis plication introduced in this study is a simple and effective method for creating double-eyelid crease and correcting mild blepharoptosis simultaneously, and provides a satisfactory outcome. As such, we recommend this method in treating patients with both single eyelid and mild blepharoptosis.

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“…Hence they used proline suture in their case for Kpro surgery with no complications and a good stability. 5 Hence proline could serve as a viable replacement for our…”

Section: Discussionmentioning

confidence: 99%

Untitled

2015

AOVS

0

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Purpose: To report a case of allergy to the nylon suture material after keratoplasty and its clinical implications Design: Case ReportObservation: Seventy-three year old man underwent penetrating keratoplasty for pseudophakic corneal edema. Post-operatively he had profuse watering, photophobia, lid margin swelling, conjunctival ballooning and corneal edema. Persistent anterior segment and ocular surface inflammation lead to extensive suture track vascularisation giving a 'fiery sun appearance'. Loose sutures required early suture removal by 2 months. Subsequently, anterior segment and ocular surface inflammation decreased. Systemic/topical corticosteroids were tapered. Retrospective diagnosis of allergy to suture material was made.Results and discussion: At 6 months follow-up, patient has BCVA 6/24, normal ocular surface, no intra-ocular inflammation and normal optic disc. This is first report of presumed nylon allergy after keratoplasty. Specific problems like uncontrolled cylinder power, unstable graft-host junction and wound over-ride due to early suture removal were encountered.On post-op day 25, the patient had severe ocular discomfort, profuse watering and photophobia. Conjunctival hyperaemia and chemosis had significantly increased. Cornea showed minimal corneal edema and significant vascularisation along the sutureline. Figure 1d one suture at 12 o'clock had become loose and was removed. Ocular symptoms and signs were persistent despite maximum corticosteroid treatment. The side-effect of the persistent ocular surface inflammation was that 15/16 sutures needed removal within 2 months of surgery. Figure 1e gradually the ocular surface stabilized, symptoms significantly decreased and the patient became comfortable. Ocular surface and anterior segment inflammation decreased over the next 1 month after suture removal. The suture-line showed scarring as a reminiscent of the vascularisation. Topical and systemic corticosteroids were tapered and moxifloxacin eye drops were stopped. At 6 months follow-up, patient has best spectacle corrected visual acuity as 6/24, best contact lens corrected visual acuity as 6/18, a normal ocular surface, no intraocular inflammation and normal optic disc. Figure 1f corneal topography shows a steep cornea with 14.6D cylinder (Figure 2) possibly due to irregular wound healing and wound gape at 4 o clock. He is currently on topical prednisolone 1% 4 times a day and carboxy-methyl-cellulose 0.5% eye drops 4 times a day. (Figure 1a) Pre-operative image showing mild corneal edema, anterior chamber intra-ocular lens with a vitreous tag going upto the corneal wound; Post-operative images at day 4 ( Figure 1b) and day 10 (Figure 1c) showing lid edema and ocular surface inflammation; Increased ocular surface inflammation, conjunctival hyperaemia and radiating suture tract vascularisation giving a 'fiery sun appearance' at day 25 ( Figure 1d DiscussionWe hereby report a case of an elderly gentleman who underwent penetrating keratoplasty for pseudophakic bullous keratopathy. The p...

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“…The symptoms had subsided after suture removal then. Hence they used proline suture in their case for Kpro surgery with no complications and a good stability [5]. Hence proline could serve as a viable replacement for our case in future for any surgical intervention if needed in this or the contralateral eye.…”

Section: Discussionmentioning

confidence: 99%

Nylon Allergy after Keratoplasty – Fiery Sun

Jain¹

2015

AOVS

0

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Purpose: To report a case of allergy to the nylon suture material after keratoplasty and its clinical implications Design: Case ReportObservation: Seventy-three year old man underwent penetrating keratoplasty for pseudophakic corneal edema. Post-operatively he had profuse watering, photophobia, lid margin swelling, conjunctival ballooning and corneal edema. Persistent anterior segment and ocular surface inflammation lead to extensive suture track vascularisation giving a 'fiery sun appearance'. Loose sutures required early suture removal by 2 months. Subsequently, anterior segment and ocular surface inflammation decreased. Systemic/topical corticosteroids were tapered. Retrospective diagnosis of allergy to suture material was made.Results and discussion: At 6 months follow-up, patient has BCVA 6/24, normal ocular surface, no intra-ocular inflammation and normal optic disc. This is first report of presumed nylon allergy after keratoplasty. Specific problems like uncontrolled cylinder power, unstable graft-host junction and wound over-ride due to early suture removal were encountered.On post-op day 25, the patient had severe ocular discomfort, profuse watering and photophobia. Conjunctival hyperaemia and chemosis had significantly increased. Cornea showed minimal corneal edema and significant vascularisation along the sutureline. Figure 1d one suture at 12 o'clock had become loose and was removed. Ocular symptoms and signs were persistent despite maximum corticosteroid treatment. The side-effect of the persistent ocular surface inflammation was that 15/16 sutures needed removal within 2 months of surgery. Figure 1e gradually the ocular surface stabilized, symptoms significantly decreased and the patient became comfortable. Ocular surface and anterior segment inflammation decreased over the next 1 month after suture removal. The suture-line showed scarring as a reminiscent of the vascularisation. Topical and systemic corticosteroids were tapered and moxifloxacin eye drops were stopped. At 6 months follow-up, patient has best spectacle corrected visual acuity as 6/24, best contact lens corrected visual acuity as 6/18, a normal ocular surface, no intraocular inflammation and normal optic disc. Figure 1f corneal topography shows a steep cornea with 14.6D cylinder (Figure 2) possibly due to irregular wound healing and wound gape at 4 o clock. He is currently on topical prednisolone 1% 4 times a day and carboxy-methyl-cellulose 0.5% eye drops 4 times a day. (Figure 1a) Pre-operative image showing mild corneal edema, anterior chamber intra-ocular lens with a vitreous tag going upto the corneal wound; Post-operative images at day 4 ( Figure 1b) and day 10 (Figure 1c) showing lid edema and ocular surface inflammation; Increased ocular surface inflammation, conjunctival hyperaemia and radiating suture tract vascularisation giving a 'fiery sun appearance' at day 25 ( Figure 1d DiscussionWe hereby report a case of an elderly gentleman who underwent penetrating keratoplasty for pseudophakic bullous keratopathy. The p...

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Prolene monofilament suture in Boston Keratoprosthesis surgery

Cited by 7 publications

References 3 publications

Simultaneous Double Eyelid Blepharoplasty and Blepharoptosis Correction With Levator Aponeurosis Plication Technique

Simultaneous Double Eyelid Blepharoplasty and Blepharoptosis Correction With Levator Aponeurosis Plication Technique

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Nylon Allergy after Keratoplasty – Fiery Sun

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