Challenge
The challenge in performing a penetrating keratoplasty (PK) is to place the sutures for donor cornea fixation in a way that no additional postoperative iatrogenic astigmatism is induced, preventing persistent vision deterioration.
One option, which proved itself throughout the history of corneal transplantation, is to fixate the corneal transplant through a running cross stitch suture – the double running crossed diagonal suture by Hoffmann with 2 x 8 bites.
As the name suggests, the challenges of this suture technique lie in the precision required to exactly place the stitches. In addition, the technique requires a precise visual estimate for gauging the dimensions, which is often associated with a shallow (long and tedious) training curve. Therefore the desired results are not always achieved.
Advantages of the instrument
- Precise marking of the needle entry and exit points
- Homogenous running cross stitch suture
- Highly reproducible
- Short training curve
- High safety for the surgeon through
independence of visual estimate - Neutral astigmatism
- Reduced risk of a vertical tilt or horizontal
torsion of the donor cornea when suturing - High topographic regularity (regular astigmatism)
- Low rate of suture loosening
- Early visual rehabilitation
- Reduction of gaping inner and outer wound margins
- Reduced rate of suture repositioning
