 Until the acceptability of the keratome-and-scissors method after the early 1940s, an essential part of cataract surgery was mastery of the von Graefe knife.With increased popularity of sutures—especially pre-placed scleral groove (McLean) sutures, it became difficult for the occasional surgeon to develop the skill required to make an acceptable von Graefe incision.If the surgeon was not ambidextrous, the use of the von Graefe knife might be even more difficult with the non-dominant hand.