In 1894 Kalt1 described the first corneoscleral suture. This consisted of two vertical bites, one in the cornea and one in the sclera, with 1 mm. between, in which the section was made. He later modified this procedure, inserting the scleral bite horizontally to make a T-shaped suture. Liégard2 further modified Kalt's suture by placing both bites horizontally. This modification is often used today.3 There are certain drawbacks to this type of corneoscleral suture. The wound is not covered by conjunctiva, although such protection may be partially obtained by a sliding Van Lint flap.4 Instead of providing perfect approximation, the vertical arms of the suture allow a certain amount of lateral displacement, and because they run up over the lips of the wound they tend to produce inversion if tied too tightly. The latter fact may predispose to epithelial downgrowth as well as to imperfect union.
McLEAN JM. A NEW CORNEOSCLERAL SUTURE. Arch Ophthalmol. 1940;23(3):554–559. doi:10.1001/archopht.1940.00860130620010
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