Scleral-flap incision for cataract surgery.
I present a technique for creating a three-stage scleral incision for extracapsular cataract extraction and intraocular lens (IOL) implantation, especially useful for cases in which phacoemulsification is contraindicated or aborted. The incision is 5 to 10 mm wide, and the scleral flap is trapezoidal and requires one to three horizontal sutures for closure. The technique was used in 364 consecutive eyes; follow up was 6 months. After 1 week, 80% of these eyes had 1.50 diopters or less of induced keratometric cylinder; at 1 month, 70% had less than 1.00 D. At 6 months, 87% had 0.50 D of against-the-rule cylinder. Less than 6% had elevated intraocular pressure (22 to 28 mm Hg); hyphema developed in 7%. Forty-nine percent had 20/40 or better vision in 1 week; 75% achieved this acuity at 1 month. Final refractions in 87% of the eyes at 6 months were -1.00 (+/- 0.75) + (+/- 1.00) x 180 degrees. This technique provides most of the benefits of small-incision cataract surgery, including rapid, stable visual recovery. IOLs of any optical size can be implanted.
Nikeghbali
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Amir-Al-Moemenin Hospital, Department of Ophthalmology, Iran Medical Science University, Tehran.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007429:Intraocular Pressure; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D012590:Sclera / Q000601:surgery*; D013524:Surgical Flaps; D013536:Suture Techniques; D014792:Visual Acuity; D014945:Wound Healing