Suturing Techniques: Continuous and Interrupted
The goals of wound closure are: uniform apposition, wound strength, and patient comfort. Implicit is the importance of minimizing postoperative astigmatism. One cannot speak about suturing technique without alluding to the marked variations in size and configuration of incisions employed for intracapsular cataract extraction. (In the presentation of this paper I will show twelve incision-and-closure techniques and will illustrate in more detail the one I have used most often.) The method of suturing depends to some extent on the size and configuration of the incision. In regard to wound size, recall that a 160° incision in clear cornea constitutes a significantly smaller orifice for lens extraction than a 160° incision at the posterior limbus. (Paton, 1978) Some surgeons prefer corneal incisions with either vertical or shelved entry into the anterior chamber. Other surgeons make a 180° incision with a Graefe knife; others routinely employ a step or half-lap incision at the posterior limbus under a limbus-based flap. The latter has been my own preference (Paton, 1971) until recently when I have begun using the clear corneal single-plane incision at an angle that I understand is advocated by J. Charleux in France.
KeywordsCataract Surgery Wound Closure Nylon Suture Posterior Limbus Corneal Astigmatism
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- Paton, D.: Lens delivery in relation to cataract incision size — the preplaced continuous locked nylon suture. In Welsh, R.C. and Welsh, J. (eds.): The Second Report on Cataract Surgery: Proceedings of the Second Biennial Cataract Surgical Congress. Miami: Miami Educational Press, 1971, pp. 178–184.Google Scholar
- Paton, D.: Intracapsular cataract extraction: personal technique preferences regarding cryoextraction and suturing. In Emery, J.M. (ed.): Current Concepts in Cataract Surgery. Selected Proceedings of the Fifth Biennial Cataract Surgical Congress, February, 1977. St. Louis: The C.V. Mosby Company, 1978. ( In press )Google Scholar