Huang Liuhui, Zhang Qi, Jin Haiying
Department of Ophthalmology, Tenth People's Hospital Affiliated to Shanghai Tongji University School of Medicine, Shanghai, China ; and.
Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
Retina. 2023 Jan 1;43(1):152-157. doi: 10.1097/IAE.0000000000002772. Epub 2020 Mar 3.
To describe a minimally invasive technique for the repair of large traumatic cyclodialysis clefts using intrascleral sewing machine suture and overhand friction knot techniques in pars plana vitrectomy.
This prospective, noncomparative, interventional case series included seven eyes of seven patients with a large traumatic cyclodialysis cleft. The sewing machine technique was modified by an intrascleral approach. The procedure was transconjunctival or subconjunctival performed without scleral flaps/grooves. An overhand friction knot was used to lead the cutting ends of the suture buried in the scleral tunnel.
The closure of the cyclodialysis cleft was achieved in seven eyes. The mean follow-up duration was 49.1 ± 15.6 weeks (range, 30-70 weeks). The intraocular pressure increased from 7.3 ± 2.1 mm Hg (range, 5-11 mmHg) preoperatively to 13.6 ± 2.4 mm Hg (range, 10-17 mmHg) postoperatively ( P < 0.01). The best-corrected visual acuity improved from a mean of 2.76 ± 2.77 logarithm of the minimum angle of resolution preoperatively to 0.63 ± 0.82 logarithm of the minimum angle of resolution at the final follow-up ( P < 0.01).
In conclusion, the present technique is safe and effective in the treatment of large traumatic cyclodialysis clefts with minimal surgical trauma and a decreased surgical duration.
描述一种在玻璃体切除术中使用巩膜内缝纫机缝合和反手摩擦结技术修复大型外伤性睫状体分离裂孔的微创技术。
本前瞻性、非对比性、介入性病例系列包括7例患有大型外伤性睫状体分离裂孔患者的7只眼。通过巩膜内入路对缝纫机技术进行了改良。该手术通过结膜或结膜下进行,无需制作巩膜瓣/沟。使用反手摩擦结将缝线的切割端引入埋于巩膜隧道内。
7只眼的睫状体分离裂孔均成功闭合。平均随访时间为49.1±15.6周(范围30 - 70周)。眼压从术前的7.3±2.1 mmHg(范围5 - 11 mmHg)升至术后的13.6±2.4 mmHg(范围10 - 17 mmHg)(P<0.01)。最佳矫正视力从术前平均最小分辨角对数2.76±2.77提高至末次随访时的0.63±0.82最小分辨角对数(P<0.01)。
总之,本技术在治疗大型外伤性睫状体分离裂孔时安全有效,手术创伤小且手术时间缩短。