Corneal epithelial changes induced by suture removal after keratoplasty

Purpose. To investigate effects of suture removal following keratoplasty on epithelial morphology and barrier function. Methods. We evaluated 34 eyes before and one month after removal of 10-0 nylon running sutures following penetrating keratoplasty. The corneal epithelium was assessed using specular microscopy and vital staining. Epithelial barrier function was measured by anterior fluorophotometry. We also performed corneal anesthesiometer and tear function tests and measured tear film break-up time. Subjective symptoms were assessed using a questionnaire completed by the patients. Results. Suture removal did not significantly affect vital staining, tear film break-up time, corneal sensitivity, or tear function. Specular microscopy of the corneal epithelium demonstrated a decrease in the number of eyes with elongated cells after suture removal (P=0.017) and the mean epithelial cell area decreased (P=0.049). Corneal epithelial permeability improved in 19 out of 34 (55.9%) eyes, but the change in the mean value was not significant (P=0.26). Overall patient satisfaction was high. Conclusions. Suture removal following keratoplasty was associated with improvements in corneal epithelial morphology. Changes in barrier function were less obvious.