Ophthalmic Microsurgical Suturing Techniques
Ophthalmic Microsurgical Suturing Techniques is a reference text for both the novice and the accomplished ophthalmic surgeon. In 15 richly illustrated chapters this book imparts basic information on tissue tactics and knot tying and demonstrates the appli
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Marian S. Macsai (Ed.)
Ophthalmic Microsurgical Suturing Techniques
With 289 Figures, mostly in Color
123
Marian S. Macsai, MD Professor and Vice Chair Ophthalmology Northwestern University Chief, Division of Ophtho Evanston Northwestern Healthcare 2050 Pfingsten Rd. Glenview, Il 60025 USA
ISBN-10 ISBN-13
3-540-28069-3 Springer Berlin Heidelberg New York 978-3-540-28069-9 Springer Berlin Heidelberg New York
Library of Congress Control Number: 2006935423 This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9th, 1965, in its current version, and permission for use must always be obtained from Springer-Verlag. Violations are liable for prosecution under German Copyright Law. Springer is part of Springer Science+Business Media. Springer.com © Springer-Verlag Berlin Heidelberg 2007 The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from relevant protective laws and regulations an therefore free general use. Product liability: The publishers cannot guarantee the accuracy of any information about dosage and application contained in this book. In every individual case the user must check such information by consulting the relevant literature. Editor: Marion Philipp, Heidelberg, Germany Desk Editor: Martina Himberger, Heidelberg, Germany Production: LE-TEX Jelonek, Schmidt & Vöckler GbR, Leipzig, Germany Illustrations: Albert R. Gattung + Regine Gattung-Petith, Edingen-Neckarhausen, Germany Typesetting: Arnold & Domnick, Leipzig, Germany Cover Design: Frido Steinen-Broo, EStudio Calamar, Spain Printed on acid-free paper
24/3100/YL
543210
Dedication
For my husband, Jack, and his never ending support and love. For Ezra, Max and Emma, my continued sources of inspiration and joy. For my parents who taught me to learn, to teach and to enjoy life.
Preface
In any surgical field, the importance of suturing is selfevident. In eye surgery, due to the lack of elasticity of the tissues and the influence of sutures on the visual outcome, proper microsurgical suturing technique is paramount. Inappropriate or careless suture placement and knot tying can impact visual function. If wound construction and closure are not astigmatically neutral, the visual outcome will be altered and further surgical intervention may be required. Wound related complications are more severe in the eye than in the skin. The close proximity of tissues allows for rapid spread of infection and the limited blood supply inhibits treatment. The same limited blood supply alters wound healing. The translation of hand tying techniques, introduced in every medical
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