Pham D T, Wollensak J, Seiler T
Augenklinik, Klinikum Rudolf Virchow der Freien Universität Berlin.
Ophthalmologe. 1994 Aug;91(4):429-33.
We use the trapezoidal lamellar incision as standard construction for sutureless self-sealing wound closure in our clinic: a 7 mm incision for phacoemulsification and implantation of a 6.5 mm optic diameter PMMA posterior chamber less (PCL) and an incision up to 11 mm for ECCE with standard PCL. The operation can be performed in a nearly closed system because of the self-sealing wound construction. Experiments in cadaver eyes showed that the wound closure of a 7 mm incision with the no-stitch technique ruptured at a pressure five times greater than the cross-stitch-sutured corneoscleral incision and in an 11 mm incision four times greater (602 +/- 149 mmHg and 150 +/- 29 mmHg). Due to the high stability of the wound closure, no sutures are necessary. Complications arising in connection with sutures are therefore avoided. Clinically, two typical postoperative complications were observed: hypotony occurred in 1% and anterior chamber hemorrhage in 5%. These complications are exclusively caused by imperfection of the internal corneal opening.
在我们诊所，我们采用梯形板层切口作为无缝合自封闭伤口闭合的标准术式：超声乳化白内障吸除术及植入直径6.5mm光学部的PMMA后房型人工晶状体（PCL）时采用7mm切口，而采用标准PCL行囊外白内障摘除术（ECCE）时采用最大达11mm的切口。由于伤口自封闭结构，手术可在近乎封闭的系统中进行。尸体眼实验表明，采用免缝技术闭合7mm切口时，伤口破裂压力比采用交叉缝合法缝合角巩膜切口时大5倍，11mm切口时大4倍（分别为602±149mmHg和150±29mmHg）。由于伤口闭合稳定性高，无需缝合。因此避免了与缝合相关的并发症。临床上，观察到两种典型的术后并发症：低眼压发生率为1%，前房出血发生率为5%。这些并发症完全是由角膜内口不完善所致。
