DURING cataract wound closure, the surgeon should have some method of being reasonably certain that no vitreous strands are trapped in the wound. The presence of characteristic iris distortion, more notable with round pupil surgery, is distinctive of vitreous incarceration in many instances; but the incarceration of a slender or tenuous vitreous strand (Fig 1) may not result in iris distortion until hours or days after wound closure. Such thin or tenuous strands of incarcerated vitreous will often persist, without iris distortion, after an obvious vitreous prolapse has been thought to be completely reposited or removed; and even a tiny incarceration may lead to any of the possible complications.
A technique which I have found to be nearly always successful in detecting such focal, or meridional, or very tiny areas of vitreous incarceration consists of placing a moistened cotton-tipped applicator at the lips of the wound (Fig 2, top) and
Broggi RJ. The Detection of Focal Vitreous Prolapse. Arch Ophthalmol. 1967;78(4):501–502. doi:10.1001/archopht.1967.00980030503017
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: