Jing Qinghe, Chen Jiahui, Chen Junyi, Tang Yating, Lu Yi, Jiang Yongxiang
Department of Ophthalmology and Vision Science, Eye and ENT Hospital of Fudan University, 83 Fenyang Rd, Shanghai, 20031, China.
Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China.
BMC Ophthalmol. 2017 Oct 27;17(1):196. doi: 10.1186/s12886-017-0582-4.
To report a case for repair of cyclodialysis after trabeculectomy with Cionni-modified capsular tension ring.
A 64-year-old man who had undergone trabeculectomy of his left eye 3 months earlier visited our clinic owing to blurred vision. His visual acuity was 20/2000 and the intraocular pressure (IOP) was 6 mmHg. Slit-lamp examination showed a shallow anterior chamber and dense cataract. Ultrasound biomicroscopy revealed 360 ° detachment of the ciliary body and suspected cyclodialysis of the trabeculectomy incision. Choroidal detachment was confirmed by B-scan ultrasonography and optical coherence tomography. Phacoemulsification was performed in which a foldable intraocular lens (IOL) was implanted in the capsular bag and a Cionni-modified capsular tension ring (MCTR) was inserted into the ciliary sulcus. The maximum focal point of the MCTR was rotated to the site of the most severe cyclodialysis and the MCTR was sutured to the sclera through its two eyelets. The patient's best-corrected visual acuity improved to 30/50 and the IOP increased to 16 mmHg after surgery. Gonioscopy and ultrasound biomicroscopy confirmed closure of the cyclodialysis and resolution of choroidal detachment.
Phacoemjulsification with implantation of an intraocular lens combined with insertion of an MCTR into the ciliary sulcus appears to be a relatively safe, effective, minimally invasive method for repairing cyclodialysis in cataract patients. Although the technique yielded good results and appeared to be safe in one patient, further studies are necessary to validate the findings on more patients and with a long-term follow-up.
报告1例使用Cionni改良型囊袋张力环修复小梁切除术后睫状体分离的病例。
一名64岁男性，3个月前接受了左眼小梁切除术，因视力模糊前来我院就诊。其视力为20/2000，眼压（IOP）为6mmHg。裂隙灯检查显示前房浅和白内障致密。超声生物显微镜检查发现睫状体360°脱离，并怀疑小梁切除术切口处有睫状体分离。B超超声检查和光学相干断层扫描证实存在脉络膜脱离。进行了超声乳化手术，将一枚可折叠人工晶状体（IOL）植入囊袋内，并将一个Cionni改良型囊袋张力环（MCTR）插入睫状沟。将MCTR的最大焦点旋转至睫状体分离最严重的部位，并通过其两个小孔将MCTR缝合至巩膜。术后患者的最佳矫正视力提高到30/50，眼压升至16mmHg。前房角镜检查和超声生物显微镜检查证实睫状体分离闭合，脉络膜脱离消退。
白内障患者行超声乳化人工晶状体植入联合MCTR睫状沟植入术似乎是一种相对安全、有效、微创的睫状体分离修复方法。尽管该技术在1例患者中取得了良好效果且似乎安全，但仍需进一步研究以在更多患者中验证该结果并进行长期随访。
