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[经结膜无缝线25G玻璃体切除术治疗儿童白内障]

[Dry transconjunctival sutureless 25-gauge vitrectomy in the treatment of pediatric cataract].

作者信息

You Cai-yun, Xie Li-xin

机构信息

State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Qingdao 266071, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2009 Aug;45(8):762-5.

Abstract

Posterior capsule opacification is the most frequent complication of pediatric cataract surgery. To prevent posterior capsule opacification, primary phacoemulsification, posterior capsulotomy and anterior vitrectomy with intraocular lens implantation is the preferred method in the treatment of pediatric cataract. Anterior vitrectomy cutter, with 18-gauge, maximum frequency at 600/min and has simultaneous cutting, irrigation and aspiration functions, is associated with more complications and poor outcomes. In 20-gauge surgery, pars plana vitrectomy is performed with two-port sclerotomy. The irrigation increases movement of vitreous and 20-gauge sclerotomy needs suture for closing. In 25-gauge surgery, the vitreous cutter can be introduced into the vitreous cavity directly though conjunctiva and sclera. The stab incision is roughly half the size of 20-gauge cutter, therefore, the sclerotomy incision can be left unsutured. Surgery with dry transconjunctival sutureless 25-gauge vitrectomy may decrease the requirement for secondary membrane surgery and the risk for retinal detachment. The application of dry transconjunctival sutureless 25-gauge vitrectomy in the treatment of pediatric cataract is reviewed.

摘要

后囊膜混浊是小儿白内障手术最常见的并发症。为预防后囊膜混浊,原发性超声乳化、后囊切开术及前路玻璃体切除术联合人工晶状体植入术是小儿白内障治疗的首选方法。18G的前路玻璃体切割器,最大频率为600次/分钟,具有同步切割、冲洗和抽吸功能,会导致更多并发症且预后较差。在20G手术中,经睫状体扁平部玻璃体切除术通过双切口巩膜切开术进行。冲洗会增加玻璃体的活动,20G巩膜切开术需要缝合关闭。在25G手术中,玻璃体切割器可直接通过结膜和巩膜进入玻璃体腔。穿刺切口大约是20G切割器切口大小的一半,因此,巩膜切开术切口无需缝合。经结膜无缝合25G玻璃体切除术可能会减少二次膜手术的需求及视网膜脱离的风险。本文对经结膜无缝合25G玻璃体切除术在小儿白内障治疗中的应用进行综述。

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