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Delayed iris prolapse with unsutured 5.1 mm clear corneal incisions
1First University Eye Hospital, Vienna, Austria.
Journal of Cataract and Refractive Surgery
|May 1, 1995
Summary
Sutureless cataract surgery incisions can lead to iris prolapse if localized pressure is applied. A radial suture is recommended for clear corneal incisions to ensure wound stability and prevent complications.
Area of Science:
- Ophthalmology
- Surgical Techniques
- Corneal Surgery
Background:
- Sutureless 5.1 mm clear corneal incision cataract surgery is a common procedure.
- Poly(methyl methacrylate) intraocular lenses are frequently implanted.
- Maintaining wound integrity is crucial for preventing postoperative complications.
Observation:
- Two cases of iris prolapse occurred after sutureless 5.1 mm clear corneal incision cataract surgery.
- Patients reported localized digital pressure applied peripheral to the temporal incision.
- Iris prolapse occurred despite the use of a 5 mm poly(methyl methacrylate) lens.
Findings:
- 5.1 mm clear corneal incisions lack sufficient stability when subjected to localized peripheral pressure.
- Iris prolapse, transient pupillary capture, and delayed endophthalmitis were observed complications.
- A translimbal transfixation technique was used to reconstruct the pupil in situ.
Implications:
- Securing clear corneal incisions with a radial 10-0 nylon suture is strongly advocated.
- Suturing provides enhanced wound stability against deformation, reducing complication risks.
- This finding is critical for optimizing patient safety in sutureless cataract surgery.