Singapore National Eye Centre, Singapore, Singapore
Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Br J Ophthalmol. 2018 Oct;102(10):1317-1319. doi: 10.1136/bjophthalmol-2018-311868. Epub 2018 Jun 11.
Polytetrafluoroethylene (Gore-Tex) suture is preferred for scleral fixation of intraocular lenses or capsular tension devices as it is more resilient to breakage than polypropylene 10-0. However, manipulation of the thick calibre and overcurved configuration of the Gore-Tex needle within the eye poses a risk of damage to the intraocular structures. Existing techniques that overcome the problem of needles within the anterior chamber involve special instruments to retrieve the suture. We describe a technique that creates a suture snare from a short segment of the Gore-Tex suture borne on a 26-gauge needle, which is used to retrieve the Gore-Tex suture safely at the scleral fixation site. The suture is threaded into the bore of the needle leaving a short length extending from the hub which is secured by inserting a 1 cc syringe acting as a handle. The needle is inserted at the scleral fixation site, and the suture trailing from the needle tip forms a loop which is externalised at the main incision. This suture snare is used to retrieve the end of the Gore-Tex suture bearing the device to the scleral fixation site when the needle and the loop of the suture are withdrawn from the eye. This technique eliminates the inappropriate needle and the need for a large sclerostomy, and is cost-effective and can also be used in combination with the conjunctival-sparing Hoffman corneoscleral pocket.
聚四氟乙烯（戈尔）缝线是巩膜固定眼内人工晶状体或囊张力环的首选缝线，因为它比聚丙烯 10-0 更有弹性，不易断裂。然而，在眼内操作戈尔缝线的粗口径和过度弯曲的缝线针，会有损伤眼内结构的风险。现有的克服前房内缝线针问题的技术需要使用特殊器械来取出缝线。我们描述了一种技术，用一段 26 号针携带的戈尔缝线的短段，制造出缝线圈套，用于在巩膜固定部位安全地取出戈尔缝线。缝线穿过针的内腔，从针尾留下一小段，通过插入一个 1 毫升注射器作为手柄来固定。将针插入巩膜固定部位，从针尖端引出的缝线形成一个环，在主要切口处外露。当针和缝线的环从眼睛中抽出时，这个缝线圈套用于取回承载器械到巩膜固定部位的戈尔缝线的末端。这种技术消除了不合适的缝线针和对大巩膜切口的需求，具有成本效益，也可以与结膜保留的霍夫曼角巩膜袋联合使用。
