Ernest P H, Neuhann T
Eye Care Physicians of Michigan, Jackson 49202, USA.
J Cataract Refract Surg. 1996 Jan-Feb;22(1):78-84. doi: 10.1016/s0886-3350(96)80274-4.
Sutureless cataract incisions should ideally remain sealed with increased intraocular pressure and be able to withstand increased external pressure to the posterior aspect. Cadaver eye studies have shown that meeting these criteria requires an internal corneal lip of at least 1.5 mm and a square wound. Scleral incisions can meet these criteria but sacrifice aesthetics and surgical efficiency. Clear corneal incisions provide aesthetics and surgical efficiency but not wound stability. An ideal incision would combined stability with aesthetics and efficiency.
We tested a posterior limbal incision to assess its stability, aesthetics, and efficiency. The incision originated at the posterior limbus within the conjunctiva, gaining about 1.0 mm in tunnel length over a clear corneal incision. This was enough to obtain a square profile for 3.0 x 3.0 mm wide incisions, while providing the aesthetics and surgical efficiency of a clear corneal incision. We compared a 3.0 x 2.0 mm posterior limbal with a 3.0 x 2.0 mm clear corneal incision. Each was tested in stepped, paracentesis, and hinged profiles.
When compared with the clear corneal incision, the posterior limbal incision is equal in aesthetics and surgical efficiency, slightly superior in patient comfort, and far more stable.
无缝线白内障切口理想情况下应在眼压升高时保持密封，并能够承受向后部施加的外部压力增加。尸体眼研究表明，要满足这些标准需要至少1.5毫米的角膜内唇和方形伤口。巩膜切口可以满足这些标准，但牺牲了美观性和手术效率。透明角膜切口提供了美观性和手术效率，但伤口稳定性不足。理想的切口应兼具稳定性、美观性和效率。
我们测试了一种后缘切口，以评估其稳定性、美观性和效率。该切口始于结膜内的后缘，比透明角膜切口在隧道长度上增加约1.0毫米。这足以使3.0×3.0毫米宽的切口获得方形轮廓，同时提供透明角膜切口的美观性和手术效率。我们将3.0×2.0毫米的后缘切口与3.0×2.0毫米的透明角膜切口进行了比较。每种切口都在阶梯状、穿刺状和铰链状轮廓下进行了测试。
与透明角膜切口相比，后缘切口在美观性和手术效率方面相当，在患者舒适度方面略优，且稳定性远更高。
