[Wound stability of the "no-stitch" technique in various incision sites and depths]
N Anders1, D T Pham, J Wollensak
1Augenklinik im Klinikum Rudolf Virchow, Freien Universität Berlin.
Background:
Supported by experiments on cadaver eyes the no-stitch technique seems to possess higher wound strength. Until now there have been no clinical trials addressing this subject. This prompted us to investigate the wound strength with varying incision depth and incision site in a prospective randomized and controlled clinical trial.
Methods:
For this study 162 patients with a 7-mm tunnel incision were recruited. They were divided into the following subgroups: Primary incision depth of 300 microns versus 500 microns, limbal incision versus scleral incision, scleral incision in 12 h position versus temporal scleral incision, limbal incision in 12-h position versus temporal limbal incision. The wound strength was measured by an ophthalmodynamometer on the first postoperative day and after 1 week at the site with the least mechanical stability adjacent and posteriorly to the primary incision.
Results:
On the first day after surgery the wound strength was best in the temporal scleral incision with an ophthalmodynamometer reading of 37.6 +/- 4.1 kPa and it was the least in the 12-h limbal incision with an ophthalmodynamometer reading of 21.8 +/- 5.4 kPa. After 1 week also the wound strength was best in the temporal scleral incision with 38.4 +/- 2.1 kPa and it was the least in 12-h limbal incision with 30.9 +/- 7.5 kPa.
Conclusions:
These findings demonstrate that the site of the primary incision is a very important factor in determining the mechanical wound strength concerning resistance against external pressure. The wound strength was best in the temporal scleral incision.
