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O C T O B E R 2 0 1 4 | O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E
vative-free enzymes to treat IFIS, but if the
condition is severe, he often opts for hooks.
He says rings are a bit faster going in and
coming out, but the hooks are less expensive,
add about 2 minutes to the typical case and
provide more exposure than the ring if the
capsular bag is loose.
Wound leakage
Corneal incisions are often self-healing, but
failing to achieve a tight wound seal can lead
to post-op infections, including endophthalmi-
tis, the potentially debilitating post-op inflam-
mation inside the eye. Dr. Rosenblum
explains, "Fluid can leak not only out of the
eye, but tears carrying bacteria can leak back
in through the wound."
He makes a very small "shelled" incision in
the cornea by cutting at a 45-degree angle
instead of a right angle, so the pressure from
inside the eye pushes the inside flap against
the outside flap to theoretically form a water-
tight seal.
"But I'm very risk-averse, so when I finish
my case and put fluid back in, I make sure the
eye is rock-hard and doesn't have a leak," says
Dr. Rosenblum. "If there's a leak, I put in a
stitch, which solves the problem."
Placing a stitch adds an extra 2 minutes to
his procedure times and an extra $20 to his
O P H T H A L M O L O G Y
