We read with interest the article by McDonnell et al in the May 2005 issue of the ARCHIVES.1 The study demonstrated the ingress of India ink through sutureless clear corneal wounds into the anterior chamber of cadaveric human globes with fluctuating intraocular pressure.
We agree with the authors that significant intraocular pressure variation may occur during eye blinking and eye squeezing. We would like to draw the attention to another important area—the release of eyelid speculum after surgery. It has been shown that use of an eyelid speculum can produce a rise in intraocular pressure related to the degree of eyelid separation.2 At the end of cataract surgery, we believe that it is important to slowly release the eyelid speculum to avoid a sudden drop of intraocular pressure. This study provides further evidence for this practice, which may reduce the inflow of ocular surface fluid through sutureless clear corneal wounds into the anterior chamber.
Yuen KSC, Cheng ACK, Chan W. Sutureless Clear Corneal Cataract Wounds and India Ink. Arch Ophthalmol. 2006;124(3):426. doi:10.1001/archopht.124.3.426-a