Mota Sergio E Hernández-Da, Castañeda-Diez Rafael, Zavala-Martínez María Teresa
Facultad de Medicina, Universidad Michoacana de San Nicolás de Hidalgo, Morelia, Michoacán, México.
Unidad Oftalmológica, Clínica David, Asociación Para Evitar la Ceguera en México (APEC), Ciudad de México, México.
Cir Cir. 2019;87(2):215-218. doi: 10.24875/CIRU.18000386.
Pupillary block induced by silicon oil in vitrectomized patients is a common condition usually treated with Nd-YAG laser iridotomy or with surgical removal of silicon oil.
A case of silicone oil pupillary block glaucoma successfully treated with a 30 G needle transfixion technique is described. We performed a non-complicated vitrectomy surgery for retinal detachment with proliferative vitreoretinopathy that included lensectomy, inferior peripheral iridectomy, and silicone oil injection. After surgery, the iridectomy became occluded with fibrous tissue and the intraocular pressure raised to 50 mmHg. After an initial Nd-YAG iridotomy was unsuccessful, we passed a 30 Ga needle through the sclerocorneal limbus and cut the fibrous tissue that blocked the iridectomy. This procedure restored the aqueous humor flow through the iridectomy, pushed back the silicone oil bubble into the vitreous cavity and lowered the intraocular pressure to normal levels.
30 Ga needle transfixion technique could be an effective, low cost, simple alternative for the treatment of silicone oil pupillary block in aphakic patients.
玻璃体切除术后硅油引起的瞳孔阻滞是一种常见情况，通常采用Nd-YAG激光虹膜切开术或手术取出硅油进行治疗。
描述了一例成功采用30G针穿刺技术治疗的硅油性瞳孔阻滞性青光眼病例。我们对伴有增殖性玻璃体视网膜病变的视网膜脱离进行了无并发症的玻璃体切除术，包括晶状体切除术、周边虹膜切除术和硅油注入术。术后，虹膜切除术被纤维组织阻塞，眼压升至50 mmHg。初次Nd-YAG激光虹膜切开术失败后，我们将一根30G的针穿过巩膜角膜缘，切断阻塞虹膜切除术的纤维组织。该操作恢复了房水通过虹膜切除术的流动，将硅油泡推回玻璃体腔，并将眼压降至正常水平。
30G针穿刺技术可能是治疗无晶状体眼患者硅油性瞳孔阻滞的一种有效、低成本且简单的替代方法。
