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Suture in Sclera for Zonulotomy*
867
NOTES, CASES, INSTRUMENTS SUTURE IN SCLERA FOR ZONULOTOMY* T U T O M U SATO,
M.D.
Tokyo, Japan I n intracapsular extraction of an immature cataract in relatively young persons, one of ten meets with difficulty in rupturing the zonules. W h e n this occurs, I press the cor nea at the 6-o'clock position with the point of Amenaber's hook while applying traction on the sclera with the suture described. 1 ' T h e pressure on the cornea combined with tension on the suture makes rupture of the zonules very easy. This method of zonulotomy can be per formed either before or after applying the erisophake or lens forceps. If it is performed before,' the surgeon can pull the suture with his left hand. If it is performed after traction on the lens is initiated, the assistant should pull on the suture. Once the zonules at the 6-o'clock position are ruptured in this way, the other zonules will be easily broken by pressure with the hook without traction on the suture. W h e n I first conceived using this method of zonulotomy, the thought foremost in my mind was the fear of bringing about a choroidal or retinal detachment. Complications of this kind have not occurred to the present in a total of 50 cases. Furthermore, this method has never retarded restoration of the anterior chamber. I n view of these facts, it seems quite harmless. W h e n zonulotomy is difficult and traction on the suture is required, it is a sign that the ciliary body and the tissues near it are healthy and traction on the suture will not cause complications. O n the other hand when the zonules are weak and rupture easily, pull ing on the suture is not required. W h e n my method is used for difficult zonulotomy on senile cataract only, and not abused on * From the Department of Ophthalmology, Juntendo University Medical School. t Sato, T.: Flexible refractor. Am. J. Ophth., 47: 692 (May) 19S9.
Fig. 1 (Sato). Zonulotomy with the use of a suture on the sclera. younger patients, in advanced myopia, and so forth, it is my belief that there will never be any complications. I have thought of using two or more su tures for zonulotomy and pulling on them one after the other or pulling on two sutures placed on opposite sides of the limbus. A t present, however, I do think the method herein reported can not be improved upon. Juntendo University Medical School.
CILIARY BLOCK WITH BENZOCAINE* I N P A I N F U L B L I N D EYES S.
P.
MATHUR,
M.S.
Bharatpur (Rajasthan), India A mixture of 2.5-percent Benzocaine with 0.5-percent quinine urea hydrochloride has been used by various workers for prolonged local analgesia. M a t h u r and Mistry 1 (1956) * From the Department of Ophthalmology, "Vic toria Hospital.
NOTES, CASES, INSTRUMENTS SUTURE IN SCLERA FOR ZONULOTOMY* T U T O M U SATO,
M.D.
Tokyo, Japan I n intracapsular extraction of an immature cataract in relatively young persons, one of ten meets with difficulty in rupturing the zonules. W h e n this occurs, I press the cor nea at the 6-o'clock position with the point of Amenaber's hook while applying traction on the sclera with the suture described. 1 ' T h e pressure on the cornea combined with tension on the suture makes rupture of the zonules very easy. This method of zonulotomy can be per formed either before or after applying the erisophake or lens forceps. If it is performed before,' the surgeon can pull the suture with his left hand. If it is performed after traction on the lens is initiated, the assistant should pull on the suture. Once the zonules at the 6-o'clock position are ruptured in this way, the other zonules will be easily broken by pressure with the hook without traction on the suture. W h e n I first conceived using this method of zonulotomy, the thought foremost in my mind was the fear of bringing about a choroidal or retinal detachment. Complications of this kind have not occurred to the present in a total of 50 cases. Furthermore, this method has never retarded restoration of the anterior chamber. I n view of these facts, it seems quite harmless. W h e n zonulotomy is difficult and traction on the suture is required, it is a sign that the ciliary body and the tissues near it are healthy and traction on the suture will not cause complications. O n the other hand when the zonules are weak and rupture easily, pull ing on the suture is not required. W h e n my method is used for difficult zonulotomy on senile cataract only, and not abused on * From the Department of Ophthalmology, Juntendo University Medical School. t Sato, T.: Flexible refractor. Am. J. Ophth., 47: 692 (May) 19S9.
Fig. 1 (Sato). Zonulotomy with the use of a suture on the sclera. younger patients, in advanced myopia, and so forth, it is my belief that there will never be any complications. I have thought of using two or more su tures for zonulotomy and pulling on them one after the other or pulling on two sutures placed on opposite sides of the limbus. A t present, however, I do think the method herein reported can not be improved upon. Juntendo University Medical School.
CILIARY BLOCK WITH BENZOCAINE* I N P A I N F U L B L I N D EYES S.
P.
MATHUR,
M.S.
Bharatpur (Rajasthan), India A mixture of 2.5-percent Benzocaine with 0.5-percent quinine urea hydrochloride has been used by various workers for prolonged local analgesia. M a t h u r and Mistry 1 (1956) * From the Department of Ophthalmology, "Vic toria Hospital.