Shazly Tarek A, Latina Mark A
Department of Ophthalmology, Massachusetts Eye and Ear Infirmary/Harvard Medical School, Boston, Massachusetts, USA.
Ophthalmic Surg Lasers Imaging. 2012 Jan-Feb;43(1):72-5. doi: 10.3928/15428877-20111020-01. Epub 2011 Oct 27.
The authors demonstrate a reproducible technique using processed pericardium to seal sclerostomy track during glaucoma shunt revision. The suggested method involves placement of a wedge-shaped processed pericardial graft into the old sclerostomy tract following tube explantation. The graft is trimmed and sutured to the sclera. The tube is reinserted into a new sclerostomy and then sutured in place and covered in the usual fashion. This method allowed relatively easy treatment of three patients with patulous sclerostomy with necrotic edges. A successful tube revision and repositioning of the tube using this technique was performed on three patients with exposed tubes. The intraocular pressure was between 8 and 12 mm Hg from postoperative day 1. The authors suggest the use of pericardium plug to adequately seal the old sclerostomy track during glaucoma shunt revision. The plug allows tube repositioning at a new site without the need to suture the friable sclerostomy edges.
作者展示了一种可重复的技术，即在青光眼分流修复术中使用处理过的心包来封闭巩膜造瘘通道。建议的方法包括在取出引流管后，将楔形处理过的心包移植物放置到旧的巩膜造瘘通道中。将移植物修剪后缝合到巩膜上。将引流管重新插入新的巩膜造瘘口，然后缝合固定，并按常规方式覆盖。该方法使相对容易地治疗了3例巩膜造瘘口扩张且边缘坏死的患者。对3例引流管外露的患者使用该技术成功进行了引流管修复和重新定位。术后第1天眼压在8至12毫米汞柱之间。作者建议在青光眼分流修复术中使用心包塞来充分封闭旧的巩膜造瘘通道。该塞子允许在新位置重新定位引流管，而无需缝合脆弱的巩膜造瘘边缘。
