BACKGROUND AND OBJECTIVE: To evaluate the usefulness of a 20-gauge cannula to maintain a selfsealing sclerotomy wound after 23-gauge phacofragmentation. PATIENTS AND METHODS: This retrospective study compared the suture rates after 23-gauge phacofragmentation when the 23-gauge cannula was temporarily replaced with a 20-gauge valved metal cannula versus when the 23-gauge fragmatome was inserted at the sclerotomy site without a cannula. RESULTS: Whereas a sclerotomy was sutured in all 31 eyes in the without-cannula group, only one eye of 14 in the cannula group required a sclerotomy suture (P < .0001). However, there was one case of fragmatome tip fracture during fragmentation in the cannula group. CONCLUSION: A self-sealing sclerotomy wound can be maintained without suturing by using a 20-gauge metal cannula, but fragmatome tip fracture can occur during fragmentation.
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