[Etiology of insufficient wound sealing in cataract operation with the no-stitch technique].
BACKGROUND
The no-stitch technique has become a standard procedure in cataract surgery in a short time. Nevertheless, it could be necessary--especially when learning this technique--to use a suture to close the wound.


METHODS
In this study we examined 24 patients who needed a suture from April 1991 to July 1993. By using a gonioscope we tried to find the reason for the insufficient self-sealing effect. During this period there were 7,966 cataract operations using the no-stitch tunnel technique, including about 618 eyes with a self-sealing ECCE technique.


RESULTS
In 13 eyes iris prolapse was found, in 9 eyes low IOP and in 2 eyes exceptionally astigmatism. In 11 eyes the reasons for these complications were that the inner corneal lamella was too small, in 9 eyes this lamella was cut, and in 2 eyes there was a step between this lamella and the inner surface of the cornea. The reason for the high astigmatism in 2 cases was not found in the corneal lamella, but in the scleral one which had shown a defect. The incidence of insufficient wound closure was 0.81% in ECCE (n = 618) and 0.26% in phacoemulsification surgery (n = 7348).


CONCLUSIONS
The most common reason for insufficient wound closure in the no-stitch technique is malpreparation of the corneal lamella.
Anders
N
N
Augenklinik, Klinikum Rudolf Virchow, Freien Universität Berlin.
Pham
D T
DT
Wollensak
J
J
D000368:Aged; D000369:Aged, 80 and over; D001251:Astigmatism / Q000209:etiology / Q000517:prevention & control; D002387:Cataract Extraction / Q000379:methods*; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D007499:Iris Diseases / Q000209:etiology / Q000517:prevention & control; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D011391:Prolapse; D013529:Surgical Wound Dehiscence / Q000209:etiology* / Q000517:prevention & control; D013536:Suture Techniques; D014945:Wound Healing / Q000502:physiology*
Ursachen unzureichenden Wundverschlusses bei Kataraktoperation mit No-stitch-Technik.