PubMed · 6656248
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M DuBrule. 1983. Tonsillectomy without hemorrhage.. https://pubmed.ncbi.nlm.nih.gov/6656248/
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BACKGROUND: In order to better understand the mechanism of tearing of the human lens capsule during circular capsulorhexis, scanning electron microscopic (SEM) examinations were made particularly of the rhexis edge. MATERIALS AND METHODS: Anterior segments from cornea donor eyes, as well as capsular pieces extracted during cataract surgery, were studied after fixation in glutaraldehyde, critical point drying, and sputtering with gold. RESULTS: The edges of the capsulorhexis were found to be very regular even in the area of zonular attachment. Neither the surface of the lens capsule nor the edge of the rhexis itself indicated any morphological influence on the direction of tearing. CONCLUSION: From the results we conclude that the rhexis of the lens capsule is only directed by the forces applied and not by particular morphological structures. To avoid radial tears, a deep anterior chamber, resulting in a relief of the anterior zonular portion seems most important. This minimizes radial forces on the anterior lens capsule, which provides the best condition for a safe rhexis.
The present paper introduces a new fine probe for electric cautery (1.65 mm in diameter, 22 cm long) that can be connected to a conventional cylindrical hand-controlled cautery holder, which is monopolar and widely used in general surgery. When cautery was required, a 14-gauge intravenous catheter was inserted at an appropriate site under the guidance of a videoscope. After removing the steel inner needle, the extra tube was used as the fine surgical port for the cautery probe. The position of insertion could be altered according to the operating field. Cautery was performed by conventional methods. There was no bleeding or air leakage at the site of puncture during or after surgery. The puncture wound was closed without any sutures. Based on these results, the new fine probe for cautery can reduce the number of surgical ports required for instruments during video-assisted surgery, thus improving the ease and safety of endoscopic surgery.