Wang Cong, Peng Xiao-Yan, You Qi-Sheng, Liu Yi, Pang Xiu-Qin, Zheng Peng-Fei, Jonas Jost B
Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Acta Ophthalmol. 2017 Sep;95(6):639-642. doi: 10.1111/aos.13463. Epub 2017 Jun 20.
To assess the surgical and functional outcome of internal direct cyclopexy as therapy of complicated traumatic cyclodialysis.
The single-centre interventional case-series study included eyes with traumatic cyclodialysis who had consecutively been treated. Internal cyclopexy was performed using double-armed sutures introduced into the eye through the pars plana opposite to the cyclodialysis cleft and which were laid parallel to limbus. Additional procedures included cataract surgery, and pars plana vitrectomy. The cyclodialysis was documented upon ultrasound biomicroscopy and gonioscopy.
The study included 44 patients (44 eyes). The cyclodialysis extended over 4.8 ± 3.2 clock hours of scleral spur circumference (range 1-12 hr, median 4 hr), involving >180° of the scleral spur circumference in 16 eyes (37%) and 360° in 3 eyes (7%). Besides cyclodialysis, additional trauma-related complications included hyphema, iridodialysis, lens dislocation, cataract, vitreous haemorrhage, retinal detachment, suprachoroidal haemorrhage and endophthalmitis. The surgery performed on average at 64 days after the trauma included a mean number of 4.6 ± 1.9 sutures (range: 2-9), with 1.2 sutures per 30° width of cyclodialysis. Mean follow-up was 32 ± 8 weeks (range: 6-51 weeks). Closure of the cyclodialysis was achieved in all 44 eyes, and intraocular pressure (IOP) increased from 8.0 ± 3.4 mmHg (range: 3 21 mmHg) to 14.4 ± 4.0 mmHg (range: 11-21 mmHg). Mean visual acuity (VA) improved from 2.3 ± 1.1 logMAR (range: 0.22-4.0) to 1.2 ± 0.8 logMAR (range 0.3-4.0 logMAR).
In conclusion, internal direct cyclopexy is a novel and relatively little invasive surgery technique for the repair of traumatic cyclodialysis.
评估内直视睫状体固定术治疗复杂性外伤性睫状体脱离的手术及功能效果。
这项单中心干预性病例系列研究纳入了连续接受治疗的外伤性睫状体脱离患者的眼睛。采用双臂缝线经与睫状体脱离裂孔相对的睫状体扁平部进入眼内，并与角膜缘平行放置来进行睫状体固定术。其他手术包括白内障手术和睫状体扁平部玻璃体切除术。通过超声生物显微镜检查和前房角镜检查记录睫状体脱离情况。
该研究纳入了44例患者（44只眼）。睫状体脱离累及巩膜嵴周长4.8±3.2个钟点范围（1 - 12小时，中位数4小时），16只眼（37%）累及巩膜嵴周长>180°，3只眼（7%）累及360°。除睫状体脱离外，其他与外伤相关的并发症包括前房积血、虹膜根部离断、晶状体脱位、白内障、玻璃体积血、视网膜脱离、脉络膜上腔出血和眼内炎。外伤后平均64天进行手术，平均缝线数为4.6±1.9根（范围：2 - 9根），每30°宽度的睫状体脱离用1.2根缝线。平均随访32±8周（范围：6 - 51周）。44只眼中所有睫状体脱离均闭合，眼压从8.0±3.4mmHg（范围：3 - 21mmHg）升至14.4±4.0mmHg（范围：11 - 21mmHg）。平均视力从2.3±1.1 logMAR（范围：0.22 - 4.0）提高到1.2±0.8 logMAR（范围：0.3 - 4.0 logMAR）。
总之，内直视睫状体固定术是一种用于修复外伤性睫状体脱离的新型且相对微创的手术技术。
