Article Outline
I congratulate Monteiro et al.1 for their article about scleral fixation via suture burial in a scleral cleft. Scleral suturing is done in cases in which the patient has iris problems, such as a scleral ring, or when the intraocular lens (IOL) requires suturing. In this article, the technique is used to prevent the suture ends from protruding from the conjunctiva by keeping them in the scleral cleft. After looking at other reports on this topic, I would like to make the following points:
1.This method is similar to my scleral fixation method2; however, I do not create a scleral cleft. Surgeons do not need a scleral cleft, flap, or patch to bury the suture and knot.
2.The need to prepare 2 clefts.
3.As mentioned by Monteiro et al., based on the large corneal incision, suturing of the incision could be joined to the scleral cleft. Because of this, the suturing position could be changed to 2 o'clock and 8 o'clock or 4 o'clock and 10 o'clock.
4.In my article on scleral fixation,2 the suture end with the knot is buried in the sclera. The edges will not cause problems because the knot and suture edge lie horizontally in the sclera. It is not necessary to cover the knot with a patch, graft, flap, or rotation. Additionally, the technique is easy; once it has been learned, it can be performed quickly.
The suture burial technique has been used succesfully in all my cases requiring scleral fixation.
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References
- Monteiro M, Marinho A, Borges S, et al. Scleral fixation in eyes with loss of capsule or zonule support. J Cataract Refract Surg. 2007;33:573–576
- Baykara M. Suture burial technique in scleral fixation. J Cataract Refract Surg. 2004;30:957–959
PII: S0886-3350(07)01653-7
doi:10.1016/j.jcrs.2007.08.018
© 2008 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.
