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W. N. May, H. Hertzog, J. Castro Combs, R. T. Kashiwabuchi, W. Tattiyakul, S. Qureshi-Said, A. Behrens; Sutured Step Clear Corneal Incision: Wound Apposition and Permeability to Bacterial Sized Particles. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5451.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the effects of single radial or horizontal suture placement in two-step clear cornea incision (CCI) wound apposition and permeability to particles of India ink.
Five human globes were employed. Two 25-gauge needles connected to a saline solution bag and to a digital manometer were inserted through the limbus 120° apart. Four two-step CCIs (2.75 mm wide, and 3 mm length) were constructed in each cornea. Incisions were divided in three groups: single radial suture (SRS), single horizontal suture (SHS), and unsutured group. Optical coherence tomography was performed before and after suture placement. Finally, with a preset 10 mmHg intra ocular pressure (IOP), India ink was applied to the incision site and a sudden IOP fluctuation was induced. Inflow was outlined and measured by planimetry.
The area and linear distance of India ink inflow after pressure challenge in all study groups were higher when compared to pre-pressure measurements, however this increase was only significant in the SRS group (p= 0.038). Additionally, SRS placement significantly increased inner wound gapping (p= 0.007). Though SHS also widened inner wound gaping, this increase was not significant (p= 0.180)
Single radial suture placement increased inner wound gaping and inflow of India ink. Horizontal suture and even no suturing at all are better to assure wound patency and to decrease inflow of extraocular particles after sudden changes in IOP in our ex-vivo human model. These results may have impact in the incidence of postoperative bacterial inflow after cataract surgery.
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