VA Wet Lab Session 3: Clear Corneal Wounds and Suturing the Wound

Objectives:

• To make 4 clear corneal wounds
• To fold and insert a single piece acrylic intraocular lenses into the anterior chamber
• To know about the reverse needle pass 1-1-1 suturing technique
  • Read this article: Narvaez J, Jones J, Zumwalt M, Mahdavi P. Reversed needle pass clear-corneal or limbal incision suturing technique using the 3-throw (1-1-1) adjustable square knot. J Cataract Refract Surg. 2012 Jun;38(6):929-32. doi: 10.1016/j.jcrs.2012.04.004. PubMed PMID: 22624889 (UI opthalmology residents: Video requires password. The pdf is also password protected, please see Dr. Oetting [link to Video]
• To place 8 radial, 10-0 nylon sutures in clear corneal wounds
  • Place some sutures using the traditional technique and some using a reverse needle pass technique
• Know the needle type and suture type used for clear corneal wounds.
• Describe the circumstances in which Prolene and Vicryl sutures are used during cataract surgery.

Resources:

• Henderson BA. Essentials of Cataract Surgery, second edition. Thorofare, NJ: Slack Inc., 2014. (WW 260 E78 2014). isbn 978-1-61711-0672
  • Chapter 6, Wound Construction, Pages 51-67
  • Chapter 8, Ophthalmic Viscosurgical Devices, Pages 81-85
  • Chapter 18, Suturing in Cataract Surgery, Pages 183-192
• Oetting TA, ed. Basic Principles of Ophthalmic Surgery, 2nd ed. San Francisco, American Academy of Ophthalmology, 2011. (WW 39 B311 2011)
  • Chapter 5, Pages 57-82
  • Chapter 6, Pages 83-92
  • Chapter 14, Pages 203-207 (NOTE: Not the whole chapter)
• Access to the wet lab
• Dr. Oetting's Facebook/YouTube Videos:
  • First Case Suture
  • Wound Too Long
  • Bulla bulla
  • Paracentesis too close
  • Horizontal mattress suture
  • Conjunctival donut
• Cataract Instrument Tray (EyeRounds Tutorial)
• ALSO SEE Session 4

Review Questions for Oral Exam

• Back to Lesson Index