Using a Horizontal Mattress Suture to Help Close a Large Corneal Wound

Large corneal lacerations with iris prolapse and incarceration are prone to repeated prolapse of iris tissue during the process of suturing the wound closed. Manipulation of the laceration's edges during suturing causes transient wound gape, which in turn causes the iris to prolapse further or to prolapse again after being reposited. A limbus-to-limbus horizontal mattress suture can be helpful in these situations because it stabilizes the wound by anchoring the two sides of the wound together without any manipulation of the laceration's edges. After the horizontal mattress suture is secured, the wound gape caused by edge-to-edge suture passes is reduced, and in conjunction with cohesive viscoelastic iris prolapse can be avoided. After the corneal wound is closed, the horizontal mattress suture can be removed, or it can be left in place until it loosens postoperatively.

Financial Disclosures: Dr. Christopher Sales discloses a financial relationship with Network Medical Review (Patents/Royalty). Dr. Christopher Fortenbach discloses no financial relationships.