表面麻醉下白内障手术中使用经结膜玻璃体切割系统处理玻璃体脱出
Management of vitreous loss during cataract surgery under topical anesthesia with transconjunctival vitrectomy system.
作者信息
Shah V A, Gupta S K, Chalam K V
机构信息
Department of Ophthalmology, University of Florida College of Medicine, Jacksonville, USA.
出版信息
Eur J Ophthalmol. 2003 Oct;13(8):693-6. doi: 10.1177/112067210301300805.
PURPOSE
A new technique to manage posterior capsular rupture with vitreous prolapse into the anterior chamber during phacoemulsification under topical anesthesia using the sutureless self-sealing 25-gauge transconjuctival vitrectomy system.
METHOD
In the event of vitreous prolapse into the anterior chamber, the corneal wound is sutured and cleared of vitreous. A trans conjunctival 25-gauge sclerotomy through the pars plana is made. The high speed 25-guage trans-conjunctival vitrectomy system (TVS-25) under topical anesthesia is introduced and vitrectomy is performed to clear the anterior chamber of vitreous. An anterior vitrectomy is also done. A foldable intraocular lens is subsequently inserted.
RESULTS
The vitrectomy is performed in a closed chamber maintaining normal intraocular pressure. The high-speed cutter exerts minimal traction on the vitreous. The accessibility to vitreous improves through the pars plana route ensuring more complete removal of the vitreous and restoration of normal anatomy. Topical anesthesia avoids the risks of globe perforation, retrobulbar hemorrhage, and prolonged postoperative akinesia of the eye.
CONCLUSIONS
The 25-gauge pars plana incision is small and self-sealing. This makes the procedure fast, effective, painless and safe.
目的
介绍一种在表面麻醉下使用无缝合自封闭25G经结膜玻璃体切割系统处理白内障超声乳化术中后囊破裂伴玻璃体脱出至前房的新技术。
方法
若玻璃体脱出至前房，缝合角膜伤口并清除玻璃体。经睫状体扁平部做一个25G经结膜巩膜切口。在表面麻醉下引入高速25G经结膜玻璃体切割系统（TVS-25）并进行玻璃体切割以清除前房内的玻璃体。同时也进行前部玻璃体切除术。随后植入一枚可折叠人工晶状体。
结果
玻璃体切割在封闭的眼内进行，维持正常眼压。高速切割器对玻璃体施加的牵引力极小。经睫状体扁平部途径改善了对玻璃体的可达性，确保更彻底地清除玻璃体并恢复正常解剖结构。表面麻醉避免了眼球穿孔、球后出血以及术后长时间的眼球运动不能等风险。
结论
25G睫状体扁平部切口小且能自封闭。这使得该手术快速、有效、无痛且安全。
Zotero 插件