title: Effect of scleral buckling on unsutured cataract wound strength.
abstract: OBJECTIVE
  Modern cataract surgery has evolved to include small, unsutured wounds with rapid visual rehabilitation and fewer complications. Properly constructed, these unsutured wounds can withstand increased intraocular pressures without leakage, rupture, or incarceration of intraocular contents. However, scleral buckling surgery may alter the architecture of these wounds and thus their strength. The authors wanted to study the effect of scleral buckling on the integrity of these unsutured cataract wounds.
  
  
  METHODS
  Eighteen fresh human globes underwent creation of scleral and limbal corneal incisions so as to create self-sealing wounds. Scleral buckles were then placed. Intraocular pressures were elevated to 400 mm Hg before and after placement of the scleral buckles and evidence for wound leakage was sought.
  
  
  RESULTS
  Two globes with clear corneal incisions and no scleral buckles leaked slightly at 300 mm Hg, but no globe with a scleral buckle, regardless of incision type or silicone element style, leaked at pressures to 400 mm Hg.
  
  
  CONCLUSIONS
  Sutureless cataract incisions, if properly constructed, provide a strong, pressure-resistant wound. Scleral buckling does not appear to affect the strength of these wounds.
authors.affiliation: Case Western Reserve University School of Medicine, Cleveland, OH, USA.
authors.forename: R E
authors.initials: RE
authors.lastname: Wyszynski
authors.forename: S
authors.initials: S
authors.lastname: Khosrof
authors.forename: P
authors.initials: P
authors.lastname: Shands
authors.forename: R S
authors.initials: RS
authors.lastname: Kalski
authors.forename: W E
authors.initials: WE
authors.lastname: Bruner
mesh_terms: D002387:Cataract Extraction; D006801:Humans; D007429:Intraocular Pressure; D011183:Postoperative Complications / Q000503:physiopathology / Q000517:prevention & control; D012591:Scleral Buckling / Q000379:methods*; D013536:Suture Techniques; D014945:Wound Healing / Q000502:physiology*