Micelli Ferrari T, Cardascia N, Furino C, Recchimurzo N, Boscia F, Sborgia L
Department of Ophthalmology, University of Bari, Bari, Italy.
Eur J Ophthalmol. 2003 Jul;13(6):532-5. doi: 10.1177/112067210301300604.
To describe a technique for suturing a luxated intraocular lens (IOL) in the vitreous cavity directly to the ciliary sulcus using intraocular slipknot without IOL extraction.
Noncomparative interventional case series.
A three-port vitrectomy was performed in all cases. According to the Lewis procedure, two scleral flaps and relative sclerectomies were performed at 3 and 9 o'clock position. IOL was rescued from vitreous cavity by means of perfluorocarbon and stabilized in anterior chamber by intravitreal forceps. Corneal endothelium was preserved by a dispersive ophthalmic viscosurgical device coating. Double armed 10-0 polypropylene was introduced into the vitreous cavity through the 9 o'clock sclerotomy incision and both the needles were passed out of the eye by the 3-o'clock position sclerotomy, guided by a bent 27-gauge needle 1.5 mm from the limbus. Hooking the slipknot around the haptics of the IOL in the anterior chamber by means of vitreous forceps, the 10-0 polypropylene was pulled so that the IOL haptic was fixated onto the sulcus. The same procedure was used to fixate the opposite haptic to the ciliary sulcus at the opposite position.
In all four cases, the IOL fixated stably and remained well positioned. No significant intraoperative or postoperative complications occurred.
This technique enables secure fixation of the luxated IOL in the vitreous without extracting it.
描述一种在不取出人工晶状体(IOL)的情况下,使用眼内活结将脱位至玻璃体腔的人工晶状体直接缝合至睫状沟的技术。
非对照性干预病例系列。
所有病例均行三通道玻璃体切除术。按照Lewis手术方法,在3点和9点位置制作两个巩膜瓣并进行相应的巩膜切除。通过全氟碳化合物将人工晶状体从玻璃体腔中取出,并用玻璃体镊将其稳定在前房内。使用分散性眼科粘弹剂涂层保护角膜内皮。将双股10-0聚丙烯缝线通过9点巩膜切口引入玻璃体腔,两根针在距角膜缘1.5mm处的27号弯针引导下,经3点位置的巩膜切口穿出眼外。用玻璃体镊将活结套在前房内人工晶状体的襻上,牵拉10-0聚丙烯缝线,使人工晶状体襻固定于睫状沟。用同样的方法将对侧襻固定于对侧位置的睫状沟。
4例患者人工晶状体均固定稳定,位置良好。术中及术后均未发生明显并发症。
该技术可在不取出脱位人工晶状体的情况下将其牢固固定于玻璃体。