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April 2001

Factors in the Prevention of Wound Dehiscence During Pneumatic Retinopexy

Arch Ophthalmol. 2001;119(4):621. doi:

I read with great interest the 2 cases reported by Jun et al.1 This report, however, does not provide all of the necessary details; as a result, it is difficult to accept that dehiscence of a clear corneal cataract wound can be a potential complication during a properly performed pneumatic retinopexy. The size and construction of the corneal wounds in these cases have not been mentioned. With a meticulously constructed 2- or 3-step corneal wound of no more than 3.2 mm, it is hard to believe that such a complication could occur; a corneal wound created in such a way is virtually airtight and watertight, and any rise in intraocular pressure further enhances these properties. Although intraocular pressure can rise to dangerously high levels following intravitreal gas insertion, a paracentesis to withdraw an equivalent amount of aqueous prior to intravitreal gas bubble insertion almost always prevents such a complication. Therefore, with a properly constructed corneal wound of adequate size and with paracentesis prior to gas insertion, I do not foresee a complication like wound dehiscence occurring during pneumatic retinopexy. If such a complication could occur after a modern small-incision cataract surgery, I wonder about the fate of all those who underwent classic extracapsular cataract extractions up until a few years ago!

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