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LETTER TO THE EDITOR
Year : 2021  |  Volume : 33  |  Issue : 1  |  Page : 102-103

Author's reply to comments on “comparison of the scleral tunnel constructed with crescent versus razor blade using the anterior segment optical coherence tomography”


Department of Pediatric Ophthalmology and Strabismus, Sankara Eye Hospital, Bengaluru, Karnataka, India

Date of Submission12-Mar-2021
Date of Acceptance12-Mar-2021
Date of Web Publication19-Apr-2021

Correspondence Address:
Dr. Sowmya Raveendra Murthy
No. 29/116, Rajarajeswari Nilaya, Kaveri Nagar, 1st Main, 1st Cross Bsk III stage Kathriguppe Cross, Katriguppe, B. S. K. 3rd Stage
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/kjo.kjo_67_21

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How to cite this article:
Murthy SR, Sudhakar P. Author's reply to comments on “comparison of the scleral tunnel constructed with crescent versus razor blade using the anterior segment optical coherence tomography”. Kerala J Ophthalmol 2021;33:102-3

How to cite this URL:
Murthy SR, Sudhakar P. Author's reply to comments on “comparison of the scleral tunnel constructed with crescent versus razor blade using the anterior segment optical coherence tomography”. Kerala J Ophthalmol [serial online] 2021 [cited 2021 Jun 13];33:102-3. Available from: http://www.kjophthal.com/text.asp?2021/33/1/102/314104



Dear Sir,

We appreciate the interest of authors Kaur and Gurnani, in our article entitled “Comparison of the scleral tunnel constructed with crescent versus razor blade using the anterior segment optical coherence tomography” published in the September–December issue of your esteemed journal,[1] and thank them for their gracious comments.[2]

We wish to reply to the interesting queries raised:

  1. The baseline incision length of the tunnel constructed was 5.5–6 mm on an average in all cases. The tunnel in case mentioned in abstract as having premature entry was also similar. Further, considering the fact that it was performed by a single surgeon and that all the cases were uncomplicated the details missed mention in the results section
  2. We at our institute here in the community section use the razor blade routinely for all our cases. We agree that a triplanar section is difficult with straight instrument like razor blade, but with temporal sections where eye can be moved to allow blade to reach the end of tunnel and ensure getting a dimple before entry, self-sealing section [almost a triplanar section; [Figure 1]] is obtainable
  3. Figure 1: self sealing, triplanar section

    Click here to view


    We agree that complications will be higher in inexperienced hands but in experienced hands, as seen in our study, it is a safe alternative. In beginning phases, just few steps of getting the incision and getting plane of section right is taught with blade (confirmed with crescent every time) and eventually moving up to performing the entire section with the razor blade. Moreover, this is only after learning the tunnel construction with crescent blade.

  4. With respect to the standardization of time measurement, a stop watch was used by the assisting author in observation, to record the exact time of start and completion of the tunnel construction, in synchrony with direct observation of the procedure
  5. The tunnel depth difference mentioned was according to anterior segment optical coherence tomography (62 μ difference in the mean depth). This difference in depth did not warrant suturing or intraoperative complications in our study. In cases that required suturing, which was observed in 2 cases, 1 each in the blade and the crescent group, the indication was a deeper plane of construction in both. The width of the tunnel was same in both the groups though that was not a part of our study
  6. Finally, the depth of the tunnel constructed in case of the patient with Descemet membrane detachment (DMD), the depth at external entry was 507 μ, while that at the internal plane was noted to be 523 μ. The DMD in this case was detected on table and hence managed immediately, thus improving the final outcome.


Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Murthy SR, Sudhakar P. Comparison of the scleral tunnel constructed with crescent versus razor blade using the anterior segment optical coherence tomography. Kerala J Ophthalmol 2020;32:166-70.  Back to cited text no. 1
  [Full text]  
2.
Kaur K, Gurnani B. Comment on ' Comparison of the scleral tunnel constructed with crescent versus razor blade using the anterior segment optical coherence tomography. Kerala J Ophthalmol 2020;32:331-2.  Back to cited text no. 2
  [Full text]  


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