Ernest P H, Fenzl R, Lavery K T, Sensoli A
Eye Care Physicians of Michigan, Jackson 49202, USA.
J Cataract Refract Surg. 1995 Jan;21(1):39-42. doi: 10.1016/s0886-3350(13)80477-4.
Three different clear corneal square incisions--beveled (or paracentesis), stepped, and hinged--were studied in a cadaver eye model to determine whether a critical width existed for each incision type at which resistance to external pressure changed substantially, given identical tunnel length (1.75 mm to 2.00 mm) for each incision. As a comparison, the beveled (paracentesis) incision was also performed as a clear corneal incision at the anterior limbus, making it a limbal beveled incision. One surgeon performed all procedures. Incision width ranged from 2.5 mm to 5.0 mm in 0.5 mm increments. External pressure as high as 525 psi was applied to all eyes at two ranges of intraocular pressure (10 mm Hg to 15 mm Hg and 20 mm Hg to 25 mm Hg) to determine the relative ability of each incision type to resist leakage. The hinged incision performed better than the stepped and corneal beveled incisions. When the beveled (paracentesis) incision was made as a clear corneal limbal beveled incision at the anterior limbus, the limbal structures provided additional support in resisting externally applied pressure. When the clear corneal beveled technique is used, incision width should be 3.0 mm or less. When clear corneal stepped or hinged techniques are used, incision width should be 3.5 mm or less.(ABSTRACT TRUNCATED AT 250 WORDS)
在一个尸体眼模型中研究了三种不同的透明角膜方形切口——斜角（或穿刺）切口、阶梯状切口和带蒂切口，以确定在每种切口类型中是否存在一个临界宽度，即在相同的隧道长度（1.75毫米至2.00毫米）下，外部压力的阻力会发生显著变化。作为比较，斜角（穿刺）切口也在前房角作为透明角膜切口进行，使其成为房角斜角切口。所有操作均由一名外科医生完成。切口宽度从2.5毫米到5.0毫米，以0.5毫米为增量。在两个眼压范围（10毫米汞柱至15毫米汞柱和20毫米汞柱至25毫米汞柱）下，对所有眼睛施加高达525磅力/平方英寸的外部压力，以确定每种切口类型抵抗渗漏的相对能力。带蒂切口的表现优于阶梯状切口和角膜斜角切口。当斜角（穿刺）切口在前房角作为透明角膜房角斜角切口进行时，房角结构在抵抗外部施加的压力方面提供了额外的支撑。当使用透明角膜斜角技术时，切口宽度应在3.0毫米或更小。当使用透明角膜阶梯状或带蒂技术时，切口宽度应在3.5毫米或更小。（摘要截短于250字）
