Author Affiliations: Department of Ophthalmology and Visual Sciences, University of Louisville, Louisville, Kentucky.
We read with interest the article by Gentile and Eliott describing silicone oil retention sutures for aphakic eyes with iris loss.1 This technique aims to create a physical barrier with polypropylene retention sutures that can prevent silicone oil prolapse into the anterior chamber and related complications.
This astute idea can be improved further by a simple modification to establish a uniplanar barrier against herniating silicone bubble. Bringing all the polypropylene sutures into a single plane can be accomplished by weaving the individually placed sutures into each other to form a net. For this purpose, the first 2 sets of vertical sutures are passed across the anterior chamber as described previously (Figure); however, the horizontal sutures are woven across the vertical threads by simply passing the 16-mm-long straight needle between vertical one. This way, woven polypropylene sutures (Figure) create a uniplanar net and increase their contact surface with the silicone bubble. Increased surface translates into decreased pressure at the silicone-suture interface and a lower chance for silicone to pass through the retention sutures.
Barak Y, Gambrell JD, Tezel TH. Modification of Silicone Oil Retention Sutures in Aphakic Eyes With Iris Loss. Arch Ophthalmol. 2012;130(9):1231-1232. doi:10.1001/archophthalmol.2012.1211