Effect of a superficial and a deep scleral pocket incision on the incidence of hyphema.
Deep tunnel scleral pocket incisions were developed to control surgically induced astigmatism following cataract and intraocular lens implantation surgery. A more superficial, shallow scleral pocket incision was developed to reduce the rate of postoperative hyphema. To test its effectiveness, a randomized prospective clinical study was performed. One hundred twenty-nine eyes of 129 patients were randomized: 66 to receive a deep tunnel pocket and 63 to receive the superficial pocket. In both groups the incision was made 3 mm posterior to the limbus. For the deep pocket cases, a blade setting of 0.27 mm was used and the wound was dissected forward toward the entry site, creating a long, deep, narrow tunnel. For the superficial wound cases, a 0.17 mm blade setting was used and the entire wound was dissected to the edge of the anatomic limbus, creating a thin scleral flap. The left side was then fanned out toward the left with the entry site slightly into clear cornea. At one day after surgery, 22 cases (34%) in the deep pocket group and four cases (6%) in the superficial pocket group had hyphemas. The difference in hyphema rates was statistically significant (P less than .001).
John
M E
ME
John-Kenyon Eye Research Foundation, Jeffersonville, Indiana 47130.
Noblitt
R L
RL
Boleyn
K L
KL
Raanan
M G
MG
DeLuca
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001251:Astigmatism / Q000517:prevention & control; D002387:Cataract Extraction / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006988:Hyphema / Q000209:etiology / Q000517:prevention & control*; D015994:Incidence; D007910:Lenses, Intraocular / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012590:Sclera / Q000601:surgery*; D014792:Visual Acuity