Corneal Suturing Techniques
نویسندگان
چکیده
Surgical Indications • Congenital corneal disorders • Corneal dystrophies • Corneal degenerations • Corneal scarring/opacifi cation – Infection – Infl ammation – Trauma • Graft failure • Corneal decompensation – Pseudophakic – Aphakic – Iatrogenic – Dystrophic – Traumatic Surgical Instrumentation • Operating microscope • Microsuturing instruments – Fine-toothed 0.12-mm forceps – Fine-tip needle holder – Tying forceps – 10-0 or 11-0 monofi lament suture • Trephination device • Preserved corneal tissue Surgical Technique • Appropriate tissue fi xation with forceps – Avoid compression or tissue maceration – Avoid donor endothelium • Appropriate suture placement – Equal suture length on donor and host tissue – Radial placement – Appropriate depth – Adequate knot tension • Interrupted suture placement at four cardinal positions • Avoid donor–host mismatch • Second suture is critical for placement • Look for diamond-shaped striae • Suture pattern – Interrupted technique – Combined interrupted and continuous technique – Single continuous technique – Double continuous technique Complications • Intraoperative – Iris, lens, or vitreous prolapse – Iris trauma/iris incarceration with suture – Traumatic cataract – Suprachoroidal hemorrhage – Donor–recipient mismatch • Postoperative – Astigmatism – Infection ( suture abscess, graft ulcer, endophthalmitis) – Wound leak ( fl at or narrow chamber) – Traumatic cataract – Iris trauma (hyphema, peripheral synechiae, iris suture entrapment)
منابع مشابه
Suturing techniques and postoperative management in penetrating keratoplasty in the United Kingdom
AIMS To report on the suturing techniques and aspects of postoperative management in penetrating keratoplasty in the United Kingdom. METHODS A postal questionnaire was sent to 137 ophthalmic consultants identified from a Royal College of Ophthalmology database as having a special interest in anterior segment surgery. The questionnaire surveyed surgeon preferences for surgical and suturing tec...
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