EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/78719
February 2011 February 2012 EW REFRACTIVE SURGERY 81 the blade to cause some whitening of the stroma as I enter to see what my depth is," he said. "I do a three- plane incision pushing in, flattening out, and then pushing down when I want to enter the eye." Suture use? Dr. Olson recommended placing su- tures "if I even think about the inci- sion as unstable," citing a 2005 study1 wound increased endophthalmitis risk 44-fold," he said. Drs. Tyson and Arbisser place sutures in about 1:750 to 1:1,000 cases, respectively, except in pedi- atric cases where sutures are always placed. Dr. Henderson added a small percentage (0.5%) of her patients are Seidel positive on post-op day 1, but none have needed a return trip to the OR for sutures. Dr. Safran also sutures less than 1% of the time, "sometimes for the sake of prevent- ing astigmatic shifts in myopes who have with-the-rule astigmatism." In the past 13 years, Dr. Safran said he's only had two leaking paracentesis wounds that needed a bandage con- tact lens. Dr. Mackool's suture rate is "well under 1%," and he believes the ad- vent of the femtosecond laser-cre- ated incisions will reduce that rate and the use of blades will be elimi- nated. Dr. Blomquist has residents suture all wounds over 2.4 mm "and only leave unsutured smaller incisions if there is no leakage when pressure is applied with a dry Weck-Cel sponge just posterior to the incision in the absence of stro- mal hydration." EW Reference 1. Wallin T, Parker J, Jin Y, Kefalopoulos G, Olson RJ. Cohort study of 27 cases of endophthalmitis at a single institution. J Cataract Refract Surg. 2005;31(4):735-41. Editors' note: Dr. Arbisser co-developed the Arbisser-Fine Triamond blade, but has no financial interests. Drs. Blomquist, Henderson, Mackool, Olson, Safran, and Tyson have no financial interests related to this article. that found "a leaky sutureless Your ASCRS membership now lets you take the ASCRS Symposium home. With the new ASCRS MediaCenter all the highlights of ASCRS 2011 are now right on your computer. Films, papers and posters exactly as they were presented in an easy-to-use and fully-searchable format. See what you missed or re-visit what you liked most. Search by topic, presenter or key-word. It's the best of ASCRS without leaving home. Log in at www.ascrs.org and click on ASCRS MediaCenter in the left-hand column for complete access. Make your ASCRS membership work harder! Begin learning today! Contact information Arbisser: 563-323-2020, drlisa@arbisser.com Blomquist: 214-648-3770, preston.blomquist@utsouthwestern.edu Henderson: 617-723-2015, bahenderson@eyeboston.com Mackool: 718-728-3400, mackooleye@aol.com Olson: 801-585-6622, randallj.olson@hsc.utah.edu Safran: 609-896-3931, safran12@comcast.net Tyson: 239-542-2020, tysonfc@hotmail.com