Fig. 1
Vertical sutures
Horizontal Sutures
Horizontal sutures, on the other hand, are more physiological. Being oriented perpendicular to the inner corneal lip, they do not affect it. They close the wound by approximation of the sclera flap with underlying tissue [3].
The following types of horizontal sutures are used.
(a)
Shepherd’s single horizontal suture
(b)
Fine’s infinity suture
Shepherd’s single horizontal suture
This is a vertical mattress suture which is placed horizontally.
It offers two advantages. More area of apposition between the roof and floor of scleral tunnel. Being oriented tangentially to the limbus, the compressive force of the suture does not change the corneal curvature. Hence, astigmatism is minimal (Fig. 2).
Fig. 2
Horizontal sutures
The other sutures were developed based on modifications of this suture.
Fine’s Infinity Suture
It is just a modification of Shepherd’s sutures. To make as the figure of “infinity” (Fig. 3a–c).
Fig. 3
(a) Horizontal infinity sutures. (b) Horizontal infinity sutures. (c) Horizontal infinity sutures
Crossed Mattress Sutures
To pass the needle diagonally. The external appearance may be cross (X) type (Fig. 4a) or it appears as two vertical sutures (Fig. 4b). The strength is very good in cross mattress sutures with less sagging of the posterior lip and less astigmatism.
