虹膜根部离断修复——一种简化的方法。

Iridodialysis repair - A simplified approach.

机构信息

Department of Cataract and IOL services, Aravind Eye Hospital, Madurai, Tamil Nadu, India.

出版信息

Indian J Ophthalmol. 2022 Mar;70(3):1073. doi: 10.4103/ijo.IJO_428_22.

DOI:10.4103/ijo.IJO_428_22

PMID:35225586

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9114554/

Abstract

BACKGROUND

Iris root is the thinnest and weakest portion of the iris stroma. It can detach easily due to blunt trauma or accidental engagement of the iris during intraocular surgery resulting in glare, photophobia and monocular diplopia. Multiple techniques described for iridodialysis repair such as hang back technique, stroke and dock technique and sewing machine technique are technically challenging.

PURPOSE

To describe an simplified approach of iridodialysis repair using 9-0 prolene suture.

SYNOPSIS

We demonstrate the technique of iridodialysis repair using animation for better understanding. Scleral flap is made adjacent to the iridodialysis area and a paracentesis is made oppsite to the iridodialysis. One arm of the double armed straight needle with 9-0 prolene suture is passed through the paracentesis into the iris root and docked in the 26G needle which is passed underneath the scleral flap 1.5mm posterior to the limbus. Then the needle is pulled out underneath the scleral flap and the manoeuvre is repeated for the second arm as well. The sutures are secured with 5-6 knots under the scleral flap. Intra-operative surgical videos of two patients with traumatic cataract and iridodialysis following blunt trauma are shown. After stabilizing the detached iris using iris hooks, phacoemlsification is done with implantation of foldable acrylic IOL, followed by iridodialysis repair as described above. Both the patients were relieved of their pre-operative symtoms and had good visual recovery.

HIGHLIGHTS

We describe a simplified approach of iridodialysis repair that can significantly reduce the patient's troublesome symptoms such as glare and monocular double vision.

ONLINE VIDEO LINK

https://youtu.be/-axYnSfWSb0.

摘要

背景

虹膜根是虹膜基质最薄、最脆弱的部分。由于眼内手术中虹膜的钝性创伤或意外接触，虹膜根很容易脱离，导致畏光、怕光和单眼复视。描述虹膜根部脱离修复的多种技术，如回拉技术、划动技术和缝纫机技术，技术上具有挑战性。

目的

描述一种使用 9-0 prolene 缝线修复虹膜根部脱离的简化方法。

概要

我们通过动画演示来展示虹膜根部脱离修复技术，以帮助更好地理解。在虹膜根部脱离区域附近制作巩膜瓣，并在对侧虹膜根部脱离区域做一个房穿刺。将带有 9-0 prolene 缝线的双直针穿过房穿刺进入虹膜根部，并在巩膜瓣下 1.5mm 处穿过 26G 针，将缝线的一端固定在针上。然后将针从巩膜瓣下拔出，并对另一端重复同样的操作。将缝线在巩膜瓣下固定 5-6 个结。展示了两名因钝性创伤导致外伤性白内障和虹膜根部脱离的患者的术中手术视频。使用虹膜钩稳定脱离的虹膜后，进行白内障超声乳化吸出术，并植入折叠式丙烯酸人工晶状体，然后按照上述方法进行虹膜根部脱离修复。两名患者的术前症状均得到缓解，视力恢复良好。