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“Pinch and Stretch” technique to overcome ocular hypotony during scleral suturing of recti muscles

During extraocular muscle surgery, an uneventful scleral suture pass is very essential. In presence of normal intraocular tension, the surgery is quite predictable and safe. However, in the presence of significant hypotony, it becomes challenging. Therefore, to mitigate complication rate in these ca...

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Autores principales: Pujari, Amar, Yadav, Bhupender, Modaboyina, Sujeeth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10491065/
https://www.ncbi.nlm.nih.gov/pubmed/37417143
http://dx.doi.org/10.4103/IJO.IJO_3189_22
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author Pujari, Amar
Yadav, Bhupender
Modaboyina, Sujeeth
author_facet Pujari, Amar
Yadav, Bhupender
Modaboyina, Sujeeth
author_sort Pujari, Amar
collection PubMed
description During extraocular muscle surgery, an uneventful scleral suture pass is very essential. In presence of normal intraocular tension, the surgery is quite predictable and safe. However, in the presence of significant hypotony, it becomes challenging. Therefore, to mitigate complication rate in these cases, we have adopted a simple technique, that is, the “pinch and stretch” technique. The surgical steps of this technique are as follows: In eyes with significant ocular hypotony, the surgery is initiated with a routine forniceal/limbal peritomy, following which the muscle is sutured and dis-inserted. Using three tissue fixation forceps, the scleral surface is stabilized. Using first forceps, the surgeon rotates the globe toward themself from the muscle stump, and with the remaining two forceps, the assistant pinches and stretches the episcleral tissue in an outward and upward direction just beneath the intended marks. This creates a flat scleral surface with significant firmness. Sutures are passed over this rigid sclera and the surgery is completed without any complications.
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spelling pubmed-104910652023-09-09 “Pinch and Stretch” technique to overcome ocular hypotony during scleral suturing of recti muscles Pujari, Amar Yadav, Bhupender Modaboyina, Sujeeth Indian J Ophthalmol Surgical Technique During extraocular muscle surgery, an uneventful scleral suture pass is very essential. In presence of normal intraocular tension, the surgery is quite predictable and safe. However, in the presence of significant hypotony, it becomes challenging. Therefore, to mitigate complication rate in these cases, we have adopted a simple technique, that is, the “pinch and stretch” technique. The surgical steps of this technique are as follows: In eyes with significant ocular hypotony, the surgery is initiated with a routine forniceal/limbal peritomy, following which the muscle is sutured and dis-inserted. Using three tissue fixation forceps, the scleral surface is stabilized. Using first forceps, the surgeon rotates the globe toward themself from the muscle stump, and with the remaining two forceps, the assistant pinches and stretches the episcleral tissue in an outward and upward direction just beneath the intended marks. This creates a flat scleral surface with significant firmness. Sutures are passed over this rigid sclera and the surgery is completed without any complications. Wolters Kluwer - Medknow 2023-07 2023-07-05 /pmc/articles/PMC10491065/ /pubmed/37417143 http://dx.doi.org/10.4103/IJO.IJO_3189_22 Text en Copyright: © 2023 Indian Journal of Ophthalmology https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Surgical Technique
Pujari, Amar
Yadav, Bhupender
Modaboyina, Sujeeth
“Pinch and Stretch” technique to overcome ocular hypotony during scleral suturing of recti muscles
title “Pinch and Stretch” technique to overcome ocular hypotony during scleral suturing of recti muscles
title_full “Pinch and Stretch” technique to overcome ocular hypotony during scleral suturing of recti muscles
title_fullStr “Pinch and Stretch” technique to overcome ocular hypotony during scleral suturing of recti muscles
title_full_unstemmed “Pinch and Stretch” technique to overcome ocular hypotony during scleral suturing of recti muscles
title_short “Pinch and Stretch” technique to overcome ocular hypotony during scleral suturing of recti muscles
title_sort “pinch and stretch” technique to overcome ocular hypotony during scleral suturing of recti muscles
topic Surgical Technique
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10491065/
https://www.ncbi.nlm.nih.gov/pubmed/37417143
http://dx.doi.org/10.4103/IJO.IJO_3189_22
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