Anders N, Pham D T, Wollensak J
Augenklinik, Klinikum Rudolf Virchow, Freien Universität Berlin.
Ophthalmologe. 1995 Jun;92(3):270-3.
The no-stitch technique has become a standard procedure in cataract surgery in a short time. Nevertheless, it could be necessary--especially when learning this technique--to use a suture to close the wound.
In this study we examined 24 patients who needed a suture from April 1991 to July 1993. By using a gonioscope we tried to find the reason for the insufficient self-sealing effect. During this period there were 7,966 cataract operations using the no-stitch tunnel technique, including about 618 eyes with a self-sealing ECCE technique.
In 13 eyes iris prolapse was found, in 9 eyes low IOP and in 2 eyes exceptionally astigmatism. In 11 eyes the reasons for these complications were that the inner corneal lamella was too small, in 9 eyes this lamella was cut, and in 2 eyes there was a step between this lamella and the inner surface of the cornea. The reason for the high astigmatism in 2 cases was not found in the corneal lamella, but in the scleral one which had shown a defect. The incidence of insufficient wound closure was 0.81% in ECCE (n = 618) and 0.26% in phacoemulsification surgery (n = 7348).
The most common reason for insufficient wound closure in the no-stitch technique is malpreparation of the corneal lamella.
无缝线技术在短时间内已成为白内障手术的标准术式。然而，特别是在学习该技术时，可能有必要使用缝线来关闭伤口。
本研究纳入了1991年4月至1993年7月期间需要缝线的24例患者。我们使用前房角镜试图找出伤口自闭效果不佳的原因。在此期间，共进行了7966例采用无缝线隧道技术的白内障手术，其中包括约618例采用自闭式囊外白内障摘除术的眼睛。
发现13只眼有虹膜脱垂，9只眼眼压低，2只眼有明显散光。11只眼中，这些并发症的原因是角膜内板过小；9只眼中，该内板被切断；2只眼中，该内板与角膜内表面之间有台阶。2例高度散光的原因并非在角膜板层中发现，而是在巩膜板层中发现有缺损。自闭式囊外白内障摘除术（n = 618）中伤口闭合不全的发生率为0.81%，超声乳化手术（n = 7348）中为0.26%。
无缝线技术中伤口闭合不全最常见的原因是角膜板层准备不当。
