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微周边虹膜切除术治疗二期人工晶状体植入术中棘手的虹膜后粘连松解

Microperipheral Iridectomy for Troublesome Posterior Synechiolysis in Secondary Intraocular Lens Implantation.

作者信息

Xiang Wu, Li Jing, Chen Wan, Lin Haotian, Chen Weirong

机构信息

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China.

出版信息

J Ophthalmol. 2021 Feb 23;2021:6634871. doi: 10.1155/2021/6634871. eCollection 2021.

Abstract

PURPOSE

To introduce an effective method for separating extensive posterior synechiae and those located under or adjacent to surgical incisions.

METHODS

Pediatric patients who had been subjected to cataract surgery and developed troublesome posterior synechiae requiring secondary intraocular lens (IOL) implantation were recruited. All patients underwent microperipheral iridectomy at the 12 o'clock position. Then, an ophthalmic viscosurgical device was injected into the posterior chamber through the iris fistula to mechanically separate the posterior synechiae, using scissors to cut robust posterior synechiae if necessary. The results of posterior synechiolysis and the position of the implanted IOL were analyzed.

RESULTS

Sixteen patients (median age, 51.56 months; range, 28-80 months) were included. The scope of posterior synechia in clock was 4.42 (range, 1-10). All troublesome posterior synechiae were successfully separated using the microperipheral iridectomy method, and all patients underwent IOL implantation in the ciliary sulcus. There was one case of peripheral iridectomy-related early intraoperative bleeding; no bleeding was observed at the end of surgery.

CONCLUSIONS

Microperipheral iridectomy is a useful method for the management of troublesome posterior synechiae during secondary IOL implantation in pediatric patients, which makes secondary IOL implantation an easier and safer method in some challenging cases.

摘要

目的

介绍一种分离广泛后粘连以及位于手术切口下方或附近的后粘连的有效方法。

方法

招募接受过白内障手术并出现需要二期人工晶状体(IOL)植入的麻烦后粘连的儿科患者。所有患者均在12点位进行微周边虹膜切除术。然后,通过虹膜瘘将眼科粘弹剂注入后房以机械分离后粘连,必要时用剪刀剪开牢固的后粘连。分析后粘连松解的结果以及植入IOL的位置。

结果

纳入16例患者(中位年龄51.56个月;范围28 - 80个月)。后粘连的钟点数范围为4.42(范围1 - 10)。所有麻烦的后粘连均通过微周边虹膜切除术方法成功分离,所有患者均在睫状沟植入IOL。有1例与周边虹膜切除术相关的术中早期出血;手术结束时未观察到出血。

结论

微周边虹膜切除术是儿科患者二期IOL植入期间处理麻烦后粘连的一种有用方法,这使得在一些具有挑战性的病例中二期IOL植入成为一种更简便、更安全的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78ce/7929652/fd818213cfac/joph2021-6634871.001.jpg

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