Singapore National Eye Centre, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, and Singapore Eye Research Institute, Singapore.
J Cataract Refract Surg. 2012 Aug;38(8):1309-15. doi: 10.1016/j.jcrs.2012.06.011.
A technique that uses an implanted intraocular lens (IOL) to create a barrier for the management of posterior capsule rupture is described. When a rupture occurs, surgery is halted and a dispersive ophthalmic viscosurgical device (OVD) injected into the anterior chamber to prevent vitreous prolapse. The remaining nucleus is maneuvered into the anterior chamber away from the pupillary space. The posterior capsule tear is converted into a continuous curvilinear capsulorhexis where possible. Dissociated anterior vitrectomy is performed as indicated, keeping the large nuclear fragments trapped in the OVD-filled anterior chamber. An IOL is implanted in the capsular bag or sulcus with optic capture through the anterior capsulorhexis. Using reduced parameters, phacoemulsification of the remaining fragments is completed over the IOL, which functions as a barrier to seal off the vitreous cavity. Residual nuclear fragments and vitreous are cleared from beneath the optic by placing the vitreous cutter under the optic, recapturing the optic before the instruments are removed from the eye.
The author has no financial or proprietary interest in any material or method mentioned.
目的:描述一种使用植入式人工晶状体(IOL)来形成屏障以管理后囊破裂的技术。当发生破裂时,手术暂停并在前房内注射分散性眼科黏弹剂(OVD)以防止玻璃体脱出。将剩余的核移至前房远离瞳孔区。如果可能,将后囊撕裂转换为连续的环形撕囊。根据需要进行分离性前段玻璃体切除术,使大的核碎片困在充满 OVD 的前房中。通过前囊环形撕囊将 IOL 植入囊袋或巩膜内,利用光学捕获。使用降低的参数,在 IOL 上完成剩余碎片的超声乳化,IOL 作为屏障以封闭玻璃体腔。通过将玻璃体切割器置于光学下方,在器械从眼睛中取出之前重新捕获光学,从光学下方清除残留的核碎片和玻璃体。
结论:该技术为后囊破裂的管理提供了一种有效的方法。
利益冲突:作者没有任何与材料或方法相关的财务或所有权利益。