Von Graefe knife

The von Graefe knife was a tool used to make corneal incisions in cataract surgery.^[1] Use of the knife demanded a high level of skill and mastery, and was eventually supplanted by modifications of cataract surgery through the Kelman phacoemulsification technique that emphasized a small incision.^[2]

History

Until the acceptability of the keratome-and-scissors method after the early 1940s, an essential part of

of many cataract surgeons.

In the 1980s, with the ever-increasing popularity of the Kelman

were and are among the deftest in the use of the von Graefe knife. Ultraviolet-rich India with its vast rural and underclass population afflicted with nutritional eye diseases combined with a multitude of public health problems was and still is the “Land of Eye Disease and Eye Surgery“. Few Western ophthalmologists have the daily volume of eye pathology and eye surgery that faces their Indian counterparts.

It is possible for an eye to recover from an intracapsular cataract operation that entailed a 170 to 180 degree superior corneal or limbal incision without the closure of the incisional wound by means of sutures. Recovery was significantly dependent on the quality of a well-made von Graefe knife incision with a well-honed and well-maintained knife. Unlike keratome-and-scissors incision, a well-performed von Graefe knife maneuver produced a corneal or limbal incision with well-opposed edges that resulted in rapid healing and a scar that was almost invisible to the naked eye. However, a poorly made von Graefe knife incision could lead to horrendous disasters.

See also

• Instruments used in general surgery

References

External links

• Thomas A. Oetting. Old school Cataract surgery techniques. Cataract surgery for greenhorns. 30 September 2005.
• Prof. Derrick Vail’s experiences in India
• Photographs of some results of von Graefe knife cataract surgery. The photographs are to be found in the University of Iowa Eye Atlas After the Search form of The University of Iowa Eye Atlas appears, type "von Graefe" in the "Diagnosis" space . Click "Run Query". Several appropriate photographs should appear.