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ARTICLES
Year : 1983  |  Volume : 31  |  Issue : 6  |  Page : 805-806

Electro-coaptation of conjunctival wounds


Dr. Rajendra Prasad Centre for Ophthalmic Sciences All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
S K Angra
Dr. Rajendra Prasand Centre for Ophthalmic Sciences, A.I.I.M.S., New Delhi-110029
India
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Source of Support: None, Conflict of Interest: None


PMID: 6676273

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How to cite this article:
Angra S K. Electro-coaptation of conjunctival wounds. Indian J Ophthalmol 1983;31:805-6

How to cite this URL:
Angra S K. Electro-coaptation of conjunctival wounds. Indian J Ophthalmol [serial online] 1983 [cited 2020 Jun 5];31:805-6. Available from: http://www.ijo.in/text.asp?1983/31/6/805/29332

The electro-coaptive closure of conjuneti­vall wound is like a "tissue spot welding", by passing a high frequency current through a bipolar forceps to initiate a plastic adherent coagulum between the approximated edges of conjunctival wounds.

An attempt has been made to evaluate this procedure in an effort to avoid removal of con­junctival sutures which are hazardous and re­quire general anaesthesia in infants.


  Material and methods Top


40 congenital cataract simultaneous irrga­tion-aspiration cases had conjunctival wound closed by:­

l. Electro-coaptation of conjunctiva - 30 cases.

2. Vicryle suture 7 zero (continuous) - 10 cases

3. Vigin silk 7 zero (continuous) - 10 cases

The corneoscleral wound has been closed by single hurried vicryl suture.

Technique of Electro-coaptation:

(1) Conjunctival tissue is approximated with slight pressure by bipolar forceps with smooth polish surface to avoid tissue to metal adhesions [Figure - 1]. Counter fixation near the tip of coaptive bipolar forceps may be done if conjunctiva is under tension.

(2) Current activation for electrocoaptation is done in short burst for 10-20 sec. only. We have used Codman Mentor coagulator. Other equipments which can also be used are as under:­

Current settings:

Equipment Setting No.

Burton Cavitron 3-5

Week 5-6

Codman Mentor 20

Mira Diathermy (0.75 sec.) 2-3

For wet field procedure, one step higher current is required. [Figure - 2]

(3) Observe slight tissue shrinkage and pucker.

(4) The coaptive forceps should be slide along the track of the application, rather that opened apart. The latter will pull apart the Coagulum.


  Observations Top


The thirty cases of cojunctival coaptation done (approx. 150 spots in total) showed fai­lure of coaptation i.e. breaking up of coapta­tion, in 4 spots. In post-operative period 2 spots gaped only.

The reaction in the conjunctival section was of the similar nature as that of silk continuous suture. The local slight conjunctival hyperaemic reaction of the vicryl suture per­sisted till the suture is absorbed i.e. upto 40-50 days.


  Discussion Top


The procedure can be done for limbal based or fornix based flaps equally effective. This

can be done in dry or wet fields depending on the choice of the surgeon.

In the technique, the avoidance of Tenons capsule between the blades of coaptive bipolar forceps is essential otherwise the coagulum formed has no adhesive effect or graping occurs

in the post operative period.

This method makes the pateints more com­fortable and avoids any removal of sutures. When compared with Vicryal suture this pro­cedure is superior as the healing does not in­volve chemical degradation of the suture material which produces a hyperaemic local response.

The final healing is same as has been with conventional silk sutures but has reduced the operative time besides the avoidance of gen­eral anaesthesia in our cases for the removal of silk suture.


  Summary Top


Electrocoaptation procedure to coapt con­junctival wounds has been evaluated.[1]

 
  References Top

1.
Nidler M.P.,Lehman R.N. and Pavlis R.J., 1976;' Current concepts in cataract surgery, ed. Emery J.M. & Paton D., p.79. C. V. Mosby St. Louis.  Back to cited text no. 1
    


    Figures

  [Figure - 1], [Figure - 2]



 

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Material and methods
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