Discussion
peripheral aberrations, tearing, corneal damage, SFTs, cataract, infection, Endophthalmitis, eyelid fissure, photophobia
INTRAOPERATIVE COMPLICATIONS, CATARACT, ENDOPHTHALMITIS, INFECTION, MONOCULAR DIPLOPIA, COMPLICATIONS
The pupil is an essential component of the optic system of the human eye. Pupil deformation is associated with several manifestations of vision degradation, including photophobia, monocular diplopia, peripheral aberrations, and light scattering, all of which can reduce optical quality. In 1976, McCannel tried to perform an iris suture during extracapsular cataract surgery, which resulted in improved function of the iris from weakened to recoverable [The iris suture surgical method has been continuously improved [According to our results, the duration of pupilloplasty surgery in the SFT group was significantly shorter. A longer duration of surgery makes the patient feel tired and uncomfortable. Another advantage of SFT is that it reduces the number of times the microhook enters the AC; on average, the hook enters one time for each knot. Each time the anterior chamber is breached, the risk of infection and corneal endothelial cell loss increases. Endophthalmitis rates were found to be substantially higher among patients undergoing cataract surgery combined with other ocular procedures [In our study, there were no significant differences in knot slippage after surgery between the two groups, and only one eye in the DTT group had knot slippage during the 1-month follow-up. We speculated that the same direction of double knots may form a sliding knot. The surgeon should be able to identify the parallel configuration of the polypropylene sutures, thus confirming the correct orientation of the sutures inside the anterior chamber, which may lead to an increased risk of a sliding knot among unskilled surgeons. Moreover, simplifying the knotting technique can significantly circumvent the challenges of learning this surgical skill. The SFT group had better overall performances in pupilloplasty suturing. There was a performance difference in surgical time and AC entrance times between the two groups. Taking care to avoid breaching the AC can significantly reduce surgical time and complications.There were no significant differences in the iris tear rates during suturing between the two groups because the modified Siepser knotting technique was performed in situ, which reduced the excessive pulling on the iris. Additionally, the chance of tearing is low if the iris tissue has sufficient elasticity and if the instrument provides auxiliary traction to flatten the iris tissue, which is convenient for determining the appropriate suture point. However, we should not require pupils to be round and accurate in size, and it is not necessary to completely suture outside the eyelid fissure area due to the upper and lower eyelid margin cover effect. The postoperative symptom evaluations showed that the AC exudate grade between the groups was not significantly different, and all symptoms could be controlled by cortisol eye drops within one or two weeks. According to our results, we found similar postoperative CDVA and pupil diameter recovery outcomes between the SFT and DTT groups at the 6-month follow-up. Compared with DTTs, the patients who received SFTs seemed to have no serious complications during the follow-up period. Decreasing the time to AC can prevent extra corneal damage. In porcine surgical practice, comparison data showed that the SFT group had a significant reduction in the time to enter the AC, which prevented intraoperative complications.