New Style Suture Fixation

New suture scleral fixation technology: Pathologic and mechanical analysis of knotless transscleral Z-sutureObjective: New suture scleral fixation technology: analyze the safety and mechanical parameters of the knotless transscleral Z-suture.Methods: Fifty Japanese white rabbits were divided into five groups namely,A,B,C,D and E,according to a completely randomized design,in which the right eyes of A,B,C,D groups were the experimental sample.After making the model of aphakia and presetting suspension suture,Z-suture was respectively performed with 1,2,3,and 4 stitches.The tension was measured using a miniature dynamometer(RA?RB?RC?RD).The differences between the groups were examined.In the pathological model group E,the right eyes were the experimental sample.the right eyes were given Z-suture(3 stitches)after making the model of aphakia,rabbits died 1 day,7 days,14 days,30 days and 45 days after the surgery,respectively.The sclera tissue was stained with HE to observe the healing state of scleral suture.Results:(1)The average tension in four groups(RA,RB,RC,RD)were not all the same(P<0.001).The pairwise comparison shows that there were differences between each group(P<0.001).As the number of turns increases,the tension increases.(2)HE staining shows that a small number of inflammatory cells clustered around the suture a day after surgery;7 days after surgery,there are a large number of inflammatory cells in the sclera;14 days after surgery,inflammatory cells clustered toward the stitches;30 days after surgery,inflammatory cells were only confined around the stitches;45 days after surgery,fibrous connective tissue was formed around the stitches,and inflammatory cells were almost absent.Conclusion:(1)The tension of 3-stitch intrascleral Z-suture is sufficient to stabilize the intraocular lens.(2)HE staining suggests that sutures did not cause inflammation in the long term.Analyze a new knotless technique for transscleral Z-suture in intraocular lens suspensionObjective: To investigate the technique and safety of new knotless transscleral Z-suture in intraocular lens suspension.Methods: Aanalyze the clinical data of 27 patients(30 eyes)who underwent surgery of intraocular lens suspended with knotless transscleral z-suture,record the preoperative BCVA,postoperative BCVA,intraocular pressure,postoperative UBM,intraocular lens location,etc.,and explore the surgical method and analyze its safety.Results: The preoperative BCVA was 0.577±0.45 and the postoperative BCVA a week after surgey was 0.567±0.46,there was no statistically significant difference(P > 0.05).BCVA after a week and BCVA 0.553±0.47 after one month also did not yield any significant difference(P > 0.05).Suprachoroidal hemorrhage occurred in one eye,surgery was performed after 2 weeks,and visual acuity recovered to 0.4.Mild corneal edema occurred in 2 eyes and transient elevated intraocular pressure occurred in 3 eyes after surgery,and all of them returned to normal within one week.UBM examination was conducted one month after the operation,and the intraocular lens position is centered without dislocation or rotation.The mean follow-up time was 11.35 months,and no intraocular lens dislocation,suture exposure,conjunctival erosion,endophthalmitis etc..Conclusion: The technique of new knotless transscleral Z-suture in intraocular lens suspension is simple,with fewer postoperative complications,shorter recovery time and better visual recovery.It is a relatively safe surgical method when posterior capsule is ruptured or zonnlar fibers is abnormal.