Muzaffar Waqar, O'Duffy Desmond
Moorfields Eye Hospital, London, United Kingdom.
J Cataract Refract Surg. 2006 Feb;32(2):361-2. doi: 10.1016/j.jcrs.2005.07.019.
A case is presented that illustrates selective disinsertion and extrusion of iris tissue after blunt trauma without damage to the intraocular lens (IOL). This was an observational case report of a single patient treated as an inpatient using topical steroids and antiglaucoma drugs. Progress was monitored by tonometry and slitlamp examination. Total absence of iris tissue was discovered after resolution of hyphema with restoration of vision. Absence of iris tissue was confirmed on gonioscopy and fundoscopy. The IOL was found undisplaced and intact in the capsular bag, and visual function was restored. The insertion of foldable IOLs through self-sealing small-incision cataract sections confers protection to the globe in the face of blunt trauma in 2 ways. The self-sealing cataract section acts as a release valve during the compressive phase and allows extrusion of the disinserted iris tissue, whereas the flexible IOL absorbs the impact and prevents disruption of surrounding tissues.
本文报告了一例钝挫伤后虹膜组织选择性离断并脱出而人工晶状体(IOL)未受损的病例。这是一份对一名住院患者使用局部类固醇和抗青光眼药物治疗的观察性病例报告。通过眼压测量和裂隙灯检查监测病情进展。前房积血消退且视力恢复后,发现虹膜组织完全缺失。前房角镜检查和眼底镜检查证实了虹膜组织的缺失。发现IOL在囊袋内未移位且完好,视觉功能得以恢复。通过自密封小切口白内障手术植入可折叠IOL,在钝挫伤时可通过两种方式对眼球起到保护作用。自密封白内障切口在压缩阶段起到释放阀的作用,使离断的虹膜组织得以脱出,而柔性IOL可吸收冲击力并防止周围组织受到破坏。