Ernest P H
Mid Michigan Eye Care Center, Jackson 49202.
J Cataract Refract Surg. 1994 Mar;20(2):154-7. doi: 10.1016/s0886-3350(13)80156-3.
To evaluate whether the corneal lip tunnel incision or the sutureless closure causes any refractive problems, we performed a retrospective study on 387 cataract surgery patients who were divided into four groups based on type of wound closure and whether the corneal lip was made. The four groups consisted of patients who received an X-stitch closure without the corneal lip, a horizontal mattress stitch without the lip, a horizontal mattress stitch with the lip, and a sutureless closure with the lip. All patients had phacoemulsification in situ; implantation of a foldable silicone lens was performed through a scleral tunnel incision. Clinical evaluations included preoperative characteristics and postoperative Snellen visual acuity, intraocular pressure, and vector analysis of cylinder. In all four groups, a 4.0 mm wide incision was used. Entrance into the clear cornea during the corneal lip tunnel incision did not induce additional cylinder, and the sutureless closure did not decrease induced cylinder or increase the against-the-rule shift. The results of this study indicate that the combination of a 4.0 mm incision with 1.5 mm corneal lip, phacoemulsification in situ, foldable lens implantation, and sutureless closure is a safe and effective procedure for cataract surgery.
为评估角膜唇隧道切口或无缝线闭合是否会引起任何屈光问题，我们对387例白内障手术患者进行了一项回顾性研究，这些患者根据伤口闭合类型以及是否制作角膜唇被分为四组。这四组患者分别接受了不带角膜唇的X形缝合、不带角膜唇的水平褥式缝合、带角膜唇的水平褥式缝合以及带角膜唇的无缝线闭合。所有患者均行原位超声乳化术；通过巩膜隧道切口植入可折叠硅胶晶状体。临床评估包括术前特征以及术后的斯内伦视力、眼压和柱镜矢量分析。在所有四组中，均使用4.0毫米宽的切口。角膜唇隧道切口进入透明角膜时未诱发额外的柱镜度数，且无缝线闭合未减少诱发的柱镜度数或增加逆规偏移。本研究结果表明，4.0毫米切口联合1.5毫米角膜唇、原位超声乳化术、可折叠晶状体植入术以及无缝线闭合是一种安全有效的白内障手术方法。
