Kreissig I
Univ.-Augenklinik Tübingen, Abteilung Augenheilkunde III.
Klin Monbl Augenheilkd. 1989 Jan;194(1):27-31. doi: 10.1055/s-2008-1046331.
Two new applications of the balloon are described which exploit its variable indentation: in the first case, the volume is reduced by withdrawal of fluid; in the second it is increased by additional injection. In both cases the procedure consists in two steps performed in subconjunctival anesthesia. In the first case the balloon provides intraocular space prior to gas injection (giant tear detachment). In the first step the balloon is inserted into the parabulbar space. After one to two hours this results in a deep indentation of the globe. In the second step the balloon indentation is used to compensate for the rise in IOP induced by the gas injection. With this "balloongasprocedure", a kind of fluid-gas-exchange is performed by injecting 1.0 ml of an expanding perfluorocarbon gas without prior drainage or pars plana vitrectomy. In the second case, the balloon is used in cases of detachment to interrupt retinal circulation prior to occlusion of a recurrently hemorrhaging vessel using the laser. In the first step, the tear is tamponaded by the parabulbar balloon and with this, the artery crossing the horseshoe tear is attached as well. In the second step, by increasing the balloon volume, retinal circulation is interrupted prior to occlusion of the artery by laser with reduced risk of hemorrhage. In both applications of the balloon a relatively complex detachment operation is divided into two smaller principle of less risky procedures on the surgery in small steps.
本文描述了球囊的两种新应用,这两种应用利用了球囊可变的压痕:在第一种情况下,通过抽出液体来减少体积;在第二种情况下,通过额外注射来增加体积。在这两种情况下,手术均包括在球结膜下麻醉下进行的两个步骤。在第一种情况下,球囊在注入气体之前提供眼内空间(巨大泪液脱离)。第一步,将球囊插入球后间隙。一到两小时后,这会导致眼球出现深深的压痕。第二步,利用球囊压痕来补偿气体注入引起的眼压升高。通过这种“球囊 - 气体手术”,在不预先引流或进行玻璃体切割术的情况下,通过注入1.0毫升膨胀的全氟化碳气体进行一种液 - 气交换。在第二种情况下,在使用激光封闭反复出血的血管之前,球囊用于视网膜脱离的病例中以中断视网膜循环。第一步,球后球囊填塞撕裂处,同时附着穿过马蹄形撕裂的动脉。第二步,通过增加球囊体积,在激光封闭动脉之前中断视网膜循环,从而降低出血风险。在球囊的这两种应用中,一个相对复杂的脱离手术被分为两个较小的步骤,遵循了手术中小步骤、低风险操作的原则。