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非穿透性小梁切除术联合鼻窦切开术及丝裂霉素C术后虹膜脱出

Iris prolapse after non-penetrating trabeculectomy with sinusotomy and mitomycin C.

作者信息

Takahashi Yasuhiro, Ataka Shinsuke, Wada Sonomi, Nomura Yuya, Kohno Takeya, Shiraki Kunihiko

机构信息

Department of Ophthalmology and Visual Sciences, Osaka City University, Graduate School of Medicine, Japan.

出版信息

Osaka City Med J. 2007 Jun;53(1):49-52.

Abstract

Non-penetrating trabeculectomy (NPT) is effective in preventing numerous postoperative complications encountered with trabeculectomy. Recently, NPT has been modified to further reduce intraocular pressure (IOP) by combining other techniques. However, these modified NPT methods would make the globe even weaker than NPT alone. Here, we report a case of iris prolapse caused by blunt ocular trauma after NPT with sinusotomy and mitomycin C treatment. A 68-year-old man, who underwent NPT with sinusotomy and mitomycin C treatment, suffered from blunt ocular trauma to his left eye 28 days after surgery. The iris prolapsed from the sinusotomy site. Iridectomy, scleral suturing, and pars plana vitrectomy were performed. The bleb was absent post-re-operatively. Iris prolapse occurs uncommonly following simple NPT. However, additional sinusotomy and mitomycin C treatment render the globe weaker, and iris prolapse might occur. Iris prolapse increases risks in developing secondary infections and a loss of the filtration bleb. Thus, precautions are needed postoperatively.

摘要

非穿透性小梁切除术(NPT)在预防小梁切除术常见的多种术后并发症方面是有效的。最近,NPT已通过结合其他技术进行改良,以进一步降低眼压(IOP)。然而,这些改良的NPT方法会使眼球比单纯NPT更脆弱。在此,我们报告一例在接受NPT联合鼻窦切开术和丝裂霉素C治疗后因钝性眼外伤导致虹膜脱垂的病例。一名68岁男性在接受NPT联合鼻窦切开术和丝裂霉素C治疗后,术后28天左眼遭受钝性眼外伤。虹膜从鼻窦切开部位脱垂。进行了虹膜切除术、巩膜缝合术和平坦部玻璃体切除术。再次手术后滤过泡消失。单纯NPT后虹膜脱垂很少发生。然而,额外的鼻窦切开术和丝裂霉素C治疗会使眼球更脆弱,可能会发生虹膜脱垂。虹膜脱垂会增加继发感染和滤过泡丧失的风险。因此,术后需要采取预防措施。

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