运用模拟眼科手术进阶型小梁切除术模型眼来演示如何在小梁切除术后缝合结膜。实时手术和模拟手术画面同步播放，展示了该模拟的逼真程度。
除了Cybersight 的图书馆以外，您还可以在这里找到各种模拟手术视频，展示了使用不同类型的模拟技术来进行各种眼科手术的技巧。
Transcript
中文版字幕附于视频下方，英文原版字幕如下：
0:10 Speaker 1
In this video, Andy McNaught describes his preferred method for conjunctival closure at the end of a trabeculectomy procedure, using footage from simulated ocular surgery eyes and from live surgery.
0:24 Speaker 2
10-0 nylon is used to suture the conjunctiva. This is because nylon is inert and less likely to induce fibrosis of the bleb. I’ve passed the needle from the inside of the wound through the cornea, then out, and then repassed the suture from the outside into the wound. This is to ensure that the knot ends up deep to the surface of the conjunctiva, and does not irritate the patient.
With the simulated surgery eye, the conjunctiva has a little more elastic recoil than natural conjunctiva. So I use a 3-1-1 suturing knot formation technique to overcome this.
I pull the suture very tight. And then I cut the suture ends very short, because it’s most important there’s no nylon suture ends protruding, which will attract mucus, which will be uncomfortable for the patient.
Again, passing the nylon from the inside of the wound through the cornea, picking up some corneal collagen fibers to anchor the suture at the limbus, and then passing the nylon suture back from the outside, and then emerging from the wound to ensure the knot is buried. Use three turns. 3-1-1 (suturing knot formation technique). The suture is pulled tight, laying the knot correctly.
This pulls the conjunctival wound under great tension, to ensure that the wound is watertight. Just putting the locking turn on.
2:35
And again, cutting the suture very short, so there’s no protruding nylon suture ends to irritate the patient.
Finally, the last suture is a horizontal mattress suture. This is passed through the peripheral cornea, parallel with the limbus, which is a relatively short path, and then it’s passed through the conjunctival flap, with a relatively long pass.
Consequently, when the suture is tied tight, the conjunctiva is brought together to increase the tension across the front of the wound, and reduce the risk of aqueous leakage from the front of this wound. So very tight.
In the manner of a drawstring suture, to ensure a watertight fornix-based flap wound. 3-1-1 (suturing knot formation technique), to form the knot.
This suture is of course buried by the conjunctival flap, but again, it’s cut very short. And finally, some surgeons will then turn that knot into the cornea, to be doubly sure that it’s not going to irritate the patient.
The anterior chamber is reformed with BSS, as a final check that the releasable suture is sufficiently tight, to ensure against hypotony, so the pressure is high. The sutures are tight. The valve is not draining.
And finally, an injection of some subconjunctival antibiotic and steroid.