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无缝合25G玻璃体切割术联合虹膜爪型人工晶状体瞳孔后固定术

Sutureless 25-Gauge Pars Plana Vitrectomy Combined with Retropupillary Fixation of an Iris-Claw Intraocular Lens.

作者信息

Chalkiadakis Spyridon E, Parikakis Efstratios A, Taylor Simon R J

机构信息

Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK; School of Medicine, University of Surrey, Guildford, UK.

Athens Eye Hospital, Athens, Greece.

出版信息

Case Rep Ophthalmol. 2016 Sep 16;7(3):155-161. doi: 10.1159/000448943. eCollection 2016 Sep-Dec.

Abstract

BACKGROUND

The surgical case of a dropped intraocular lens inside the vitreous cavity constitutes a real challenge for the operating surgeon. Herein, we describe a case series where an alternative optical rehabilitation technique for late intraocular lens-bag complex dislocation has been used.

METHODS

A modern vitrectomy device was used to remove the capsule with the dropped intraocular lens using sutureless 25-gauge pars plana vitrectomy. To ensure a better aesthetic result, with faster patient recovery and a reduced number of operations, the whole procedure was performed during the same operating session; an iris-claw intraocular lens for aphakia was selected for implantation. The implant was passed behind the constricted iris with the concave surface facing it. The lens was grasped with the manufacturer's holding forceps and fixed onto the posterior surface of the iris using the special enclavation needles.

RESULTS

We have operated 12 eyes in two different clinical centres successfully, with minimal intra- and/or postoperative complications.

CONCLUSION

We believe that this is a viable solution for the visual rehabilitation of patients, who would otherwise need more than one operation for a lens exchange.

摘要

背景

人工晶状体掉入玻璃体腔的手术情况对手术医生来说是一项真正的挑战。在此,我们描述一系列病例,其中采用了一种用于晚期人工晶状体-囊袋复合体脱位的替代性光学康复技术。

方法

使用现代玻璃体切割设备,通过无缝合25G经平坦部玻璃体切割术移除带有掉落人工晶状体的囊膜。为确保更好的美学效果、加快患者恢复并减少手术次数,整个手术在同一手术过程中进行;选择植入用于无晶状体眼的虹膜爪型人工晶状体。将植入物凹面朝向收缩的虹膜并从其后方穿过。用制造商提供的镊子夹住晶状体,并使用特殊的固定针将其固定在虹膜后表面。

结果

我们在两个不同的临床中心成功为12只眼进行了手术,术中及术后并发症极少。

结论

我们认为,对于那些否则需要不止一次手术进行晶状体置换的患者,这是一种可行的视觉康复解决方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82cd/5073665/162ab982964a/cop-0007-0155-g01.jpg

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