Conjunctival Donut
Thomas A. Oetting, MS, MD
In this video are two cases in which the initial corneal incision was made posterior to the insertion of the conjunctiva. As a result of the incision being too posterior the fluid tracks back behind the conjunctiva which baloons up and if left unchecked will create a 360 degree pocket of fluid which we call a conjuctival donut. The solution is to perform a peritomy at the area of the incision to allow the fluid to leave the corneal wound without getting trapped behind the conjunctiva. In the first case this is caught early and in the second the donut is much larger. The conjunctival donut can be quite tricky as it can distort your view as fluid will collect centrally and cause a concave meniscus lens which minifies the view of the anterior chamber. Prevention is the key by detecting the problem early and making a quick peritomy.
Additional Notes: length 1:01
