Department of Physics, Shanghai University, Shanghai, China.
Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China; and.
Retina. 2023 Jul 1;43(7):1200-1203. doi: 10.1097/IAE.0000000000002904.
We will describe a minimally invasive technique for the repair of iridodialysis, without conjunctival dissections, using intrasceral fixation of a 6-0 polypropylene suture with a flanged tip.
A flange was created at the end of the suture with thermoplasticity. An ab interno passing of the needle attached to the suture was performed through the peripheral part of the iris and was further passed out from the eye 1.5 mm to 2 mm behind the limbus. Intrascleral fixation of the exterior suture was performed with the aid of the attached needle. After adjusting the tension of the iris relocation, the externalized end of the suture was cut flush to the sclera with scissors. For a wide dialysis, the same manipulations were repeated until the repair was completed.
The technique was used in three eyes of three patients. No visual impairments of monocular diplopia and glare were observed after surgery. Postoperatively, the irises remained well positioned, with no suture erosion, suture loosening, hypotony, scleral atrophy, or chronic inflammation being observed within the follow-up period. Mild postoperative hyphema was observed in one eye of blunt trauma.
The present technique provides minimal surgical invasion for the repair of iridodialysis without creations of scleral flap/groove/pocket and conjunctival dissection.
我们将描述一种微创技术,用于修复虹膜脱离,无需进行结膜切开,使用带有法兰尖端的 6-0 聚丙烯缝线进行巩膜内固定。
通过热塑性在缝线末端形成一个法兰。将附着在缝线的内眼进针穿过虹膜的周边部分,并进一步从角膜缘后 1.5 毫米至 2 毫米处穿出眼睛。借助附着的针进行巩膜内缝线固定。调整虹膜复位的张力后,用剪刀将缝线的外露端平齐剪断。对于广泛的脱离,同样的操作重复进行,直到修复完成。
该技术在 3 名患者的 3 只眼中使用。手术后,没有观察到单眼复视和眩光的视力损害。术后,虹膜位置良好,在随访期间未观察到缝线侵蚀、缝线松动、低眼压、巩膜萎缩或慢性炎症。钝挫伤的一只眼术后出现轻度眼内积血。
本技术为修复虹膜脱离提供了最小的手术侵袭,无需制作巩膜瓣/槽/袋和结膜切开。