Nick, Loop And Pull Technique Of Corneal Suture Removal.

To describe a novel, stepwise technique for removing buried or vascularized corneal sutures. The goal is to minimize common complications such as epithelial defects, wound dehiscence, and patient discomfort by avoiding traction on the overlying epithelium and preventing exposed suture from being dragged through the cornea.

Iclinix advanced eye care, New Delhi, india

This prospective case series evaluated a technique performed on 20 eyes. Under topical anesthesia at a slit lamp or operating microscope, a 26-gauge hypodermic needle is used to cleanly cut one end of an interrupted suture flush with the corneal surface. The needle tip is then inserted under the opposite end of the suture to gently lift and extricate the superficial segment from the overlying epithelium without disrupting it. The suture is then grasped at its base with forceps and removed. Epithelial integrity was assessed with fluorescein dye.

The technique was successfully performed in all 20 eyes. Immediate application of fluorescein dye demonstrated significantly less epithelial disruption compared to the linear defects characteristic of conventional methods. Patients reported minimal postoperative discomfort. No instances of wound dehiscence, broken sutures, or persistent epithelial defects were observed. The technique was found to be simple and easily reproducible by trainees.

This stepwise approach is a safe, simple, and effective technique for corneal suture removal. It is particularly advantageous for deeply buried or vascularized sutures, significantly reducing the risk of iatrogenic epithelial trauma and wound complications. This method improves patient safety and comfort and can be readily adopted.