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conjunctival incision

After a scleral corneal incision via the conjunctiva, a conjunctival incision is necessary because if the conjunctival incision is not widened, chemosis will occur during the operation and the operation will be difficult. As for the incision method, it is important to make a conjunctival incision on the extension of the corneal tunnel and make an incision from the wound opening to the cornea as shown in the movie. After perforation, make an incision so that only the conjunctiva is cut up with a slit knife that has been pulled out to the opening of the corneal wound. During ultrasonic emulsification and cortical suction, chemosis occurs when the perfusate flows out vigorously from both ends of the corneal wound and the fluid enters the subconjunctiva. The conjunctiva is highly elastic and can be pierced with a 2.4 mm slit knife, resulting in an incision width smaller than 2.4 mm. For this reason, both ends of the wound are covered with conjunctiva, and the perfusate that flows out from the wound will enter under the conjunctiva. To prevent edema, this effluent should flow over the conjunctiva. Anatomically, the conjunctiva, tenon sac, and sclera near the corneal ring are strongly adhered to each other, so an incision is required that does not peel off the adhesion and does not cover the wound.