Gimbel H V, Sun R, DeBroff B M
Gimbel Eye Centre, Calgary, Alberta, Canada.
J Cataract Refract Surg. 1995 Mar;21(2):121-4. doi: 10.1016/s0886-3350(13)80496-8.
We describe a method for recognizing and managing wound gape of the internal aspect of a scleral tunnel incision. The apposition of the cataract internal incision can be adequately assessed with the use of a gonioprism during and after surgery. With self-sealing tunnel incisions, even though the external incision may be well sealed either with or without the use of a suture, the internal incision may be inconspicuously gaping. When an internal incision gapes open, it takes on the appearance of an elongated oval opening by gonioscopy, a process we have termed fishmouthing. Often fishmouthing can be closed by rapidly deepening the anterior chamber with balanced salt solution through the paracentesis incision; if this is unsuccessful, a limbal suture may be required. Assessment of the internal incision with a gonioprism and management of internal incision fishmouthing is an important method to ensure wound stability and minimize surgically induced astigmatism.
我们描述了一种识别和处理巩膜隧道切口内口伤口裂开的方法。白内障内切口的对合情况在手术期间和术后可通过使用前房角棱镜进行充分评估。对于自封闭隧道切口，尽管外部切口无论是否使用缝线都可能密封良好，但内部切口可能会有不易察觉的裂开。当内部切口裂开时，通过前房角镜检查可呈现出细长椭圆形开口的外观，我们将这一过程称为“鱼嘴样”。通常，通过经穿刺切口用平衡盐溶液快速加深前房可闭合“鱼嘴样”；如果不成功，则可能需要缝合角膜缘。使用前房角棱镜评估内部切口以及处理内部切口“鱼嘴样”是确保伤口稳定性并将手术引起的散光降至最低的重要方法。
