When performing a scleral incision, I like to do it in two layers: making a conjunctival peritomy first, then making the scleral tunnel. Our guest surgeon, who is a very experienced MSICS surgeon, demonstrates a transconjunctival incision for MSICS and it works well. Is this similar to how retina surgeons used to do a peritomy and then insert trocars or make pars plana entry sites, but now they are doing transconjunctival trocar placement? Or is this not quite the same since in this case the conjunctival opening and the scleral incision are right on top of each other? Have you tried this technique? What is your take on it? Call me old fashioned, but I still like a two step closure for an incision this large. What do you think? Please comment below.
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