Zhu Dongqing, Zhang Jing, Zhou Jibo
1 Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
2 Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
Eur J Ophthalmol. 2018 Jul;28(4):469-471. doi: 10.1177/1120672117747018. Epub 2018 Mar 1.
To describe a new surgical technique for performing vitreous cavity lavage.
After a 23G trocar cannula was inserted into the vitreous cavity at the lowest point of the eyeball 3.5 or 4 mm posterior to the limbus, a 27G infusion line with balanced salt solution was attached to the cannula. The infusion tube was partially withdrawn and the vitreous fluid with blood flowed out through the space between the larger lumen of the cannula and the smaller infusion tube. Meanwhile, vitreous cavity was irrigated with fresh balanced salt solution through the infusion line and the intraocular pressure (IOP) was maintained. The vitreous clarity was checked by indirect ophthalmoscopy.
A total of 14 eyes of 14 patients with postvitrectomy hemorrhage were treated with the lavage technique. The vision improved and the fundus could be sufficiently viewed next day in all cases. This fluid/fluid exchange procedure was also performed in fluid/air exchange in two cases of unclosed idiopathic macular hole with switching to air infusion instead of balanced salt solution infusion.
This minimally invasive technique is a simple, safe, and efficient way of performing postvitrectomy vitreous cavity fluid/fluid or fluid/air exchange.
描述一种进行玻璃体腔灌洗的新手术技术。
在角膜缘后3.5或4毫米处眼球最低点将23G套管针插入玻璃体腔后，将带有平衡盐溶液的27G输液管连接到套管针上。部分拔出输液管，含血的玻璃体液通过套管较大管腔与较小输液管之间的间隙流出。同时，通过输液管向玻璃体腔灌注新鲜平衡盐溶液并维持眼压。通过间接检眼镜检查玻璃体清晰度。
14例玻璃体切除术后出血患者的14只眼采用该灌洗技术治疗。所有病例术后第二天视力均有改善且眼底可充分观察。在2例未闭合的特发性黄斑裂孔进行液/气交换时也采用了这种液/液交换操作，只是将平衡盐溶液灌注改为空气灌注。
这种微创技术是进行玻璃体切除术后玻璃体腔液/液或液/气交换的一种简单、安全且有效的方法。
