Nishitsuka Koichi, Yamashita Hidetoshi
Ophthalmic Surg Lasers Imaging Retina. 2014 Jun 4:1-4. doi: 10.3928/23258160-20140625-02.
To evaluate a novel surgical technique for IOL fixation using a newly designed suture thread inserter.
Scleral fixation of an IOL combined with 25-gauge vitrectomy was performed in 13 patients (eight aphakic eyes and five with IOL dislocation). Conjunctival peritomy was performed and scleral tunnels were created at the 2- and 8-o'clock positions. An infusion cannula was inserted through the inferotemporal sclera, and two cannulas were inserted through the scleral tunnels 1.5 or 2.0 mm posterior to the corneal limbus. After vitrectomy, the loop of the 10-0 polypropylene suture was inserted into the ports with a suture thread inserter. The haptics of the foldable IOL were sutured via the cow-hitch method. Haptic externalization was performed in eyes with IOL dislocation. After removing the infusion cannulas, the 10-0 polypropylene sutures were tied to scleral tunnels.
In all cases, the IOL was fixed stably and visual acuity was improved. There were no intraoperative or postoperative complications.
Scleral IOL fixation with a suture thread inserter combined with 25-gauge vitrectomy appears to be safe and minimally invasive for aphakic eyes and cases of IOL dislocation. The thread inserter mitigates the risk of hemorrhage. [Ophthalmic Surg Lasers Imaging Retina. 2014;45:xxx-xxx.].
使用新设计的缝线插入器评估一种用于人工晶状体(IOL)固定的新型手术技术。
对13例患者(8只无晶状体眼和5例人工晶状体脱位患者)进行了人工晶状体巩膜固定联合25G玻璃体切除术。行结膜环切术,并在2点和8点位制作巩膜隧道。通过颞下巩膜插入灌注套管,并在角膜缘后1.5或2.0mm处通过巩膜隧道插入两根套管。玻璃体切除术后,用缝线插入器将10-0聚丙烯缝线环插入端口。通过双套结法缝合可折叠人工晶状体的襻。对人工晶状体脱位的眼睛进行襻外置。拔除灌注套管后,将10-0聚丙烯缝线系于巩膜隧道。
所有病例中,人工晶状体均固定稳定,视力提高。无术中或术后并发症。
缝线插入器联合25G玻璃体切除术进行巩膜人工晶状体固定术对于无晶状体眼和人工晶状体脱位病例似乎是安全且微创的。缝线插入器降低了出血风险。[《眼科手术、激光与视网膜成像》。2014年;45:xxx - xxx。]