在带阀套管系统玻璃体切除术中，钻石涂层膜刮匙的硅胶头残留。
Retained silicone tip of diamond-dusted membrane scraper during vitrectomy in a valved cannula system.
作者信息
Felcida V, Kumar N, Haynes R, Habal S, Tyagi A K
机构信息
Department of Vitreoretinal Surgery, Birmingham & Midland Eye Centre, Birmingham, UK.
Department of Vitreoretinal Surgery, Bristol Eye Hospital, Bristol, UK.
出版信息
Eye (Lond). 2015 Apr;29(4):574-6. doi: 10.1038/eye.2014.325. Epub 2015 Jan 16.
PURPOSE
To report a complication of retained silicone tip from a diamond-dusted membrane scraper (DDMS) that occurred while using a valved cannula vitrectomy system.
METHOD
Retrospective review of three cases that underwent 23 gauge (G) sutureless vitrectomy for idiopathic macular hole (cases 1 and 2) and myopic macular schisis (case 3).
RESULTS
In all three cases following a standard vitrectomy, the internal limiting membrane (ILM) peeling was initiated by using a 23G DDMS. During the insertion of the DDMS, the flexible silicone tip of the 23G DDMS was detached from the metal shaft and was retained in the 23G valve system and in case 3, the silicone tip got dislodged from the valve onto the retina. Subsequent ILM peeling was completed by using an end-gripping forceps. All underwent intravitreal gas injection at the end. No other complications were noted.
CONCLUSION
These three cases demonstrate an uncommon complication of retained silicone tip within the valved cannula vitrectomy system and this complication should be considered while using flexible instruments in valved cannula systems.
目的
报告在使用带阀门的套管玻璃体切割系统时，金刚石涂层膜剥离器（DDMS）的硅胶头残留这一并发症。
方法
回顾性分析3例因特发性黄斑裂孔（病例1和2）及近视性黄斑劈裂（病例3）接受23号（G）无缝合玻璃体切割术的病例。
结果
在所有3例标准玻璃体切割术后，均使用23G DDMS开始内界膜（ILM）剥离。在插入DDMS过程中，23G DDMS的柔性硅胶头与金属杆分离，残留在23G阀门系统中，在病例3中，硅胶头从阀门上脱落至视网膜上。随后使用端部抓取镊完成ILM剥离。所有患者最后均接受了玻璃体腔注气。未发现其他并发症。
结论
这3例病例显示了带阀门的套管玻璃体切割系统中硅胶头残留这一罕见并发症，在带阀门的套管系统中使用柔性器械时应考虑到这一并发症。
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