SMT. NHL Medical College, Ahmedabad, India.
Narang Eye Care & Laser Centre, Ahmedabad, India; and.
Cornea. 2024 Apr 1;43(4):534-536. doi: 10.1097/ICO.0000000000003435. Epub 2023 Dec 28.
The aim of this study was to describe the feasibility and applicability of a reverse 4-throw (RFT) pupilloplasty technique for endothelial keratoplasty.
In RFT, the 9-0 polypropylene suture needle and a 26-Gauge needle pierce the iris tissue from the posterior surface to emerge on the anterior surface along the proximal and distal portion of iris tissue to be apposed, respectively. The 9-0 needle is threaded into the barrel of a 26-Gauge needle and is withdrawn from the eye. The suture loop is withdrawn and the suture end is passed through the loop 4 times. Both suture ends are pulled, which leads to the sliding of the loop inside the eye, thereby apposing the iris tissue with the knot lying on the posterior surface.
The procedure was performed in 11 eyes of 11 patients who were scheduled to undergo an endothelial keratoplasty procedure. The anterior segment optical coherence tomography image of the RFT pupilloplasty did not denote any presence of the suture in the anterior chamber or along the anterior surface of the iris plane. No incidence of primary graft failure or graft rejection during the entire follow-up period was reported in any of the eyes.
RFT serves as an effective technique for performing pupilloplasty in endothelial keratoplasty cases without the presence of a knot or suture tail in the anterior chamber.
本研究旨在描述一种反向四针法（RFT）瞳孔成形术用于内皮性角膜移植术的可行性和适用性。
在 RFT 中，9-0 聚丙烯缝线针和 26-Gauge 针从后表面刺穿虹膜组织，分别从前表面穿出，沿待贴合的虹膜组织的近端和远端部分。9-0 针穿入 26-Gauge 针的筒内，并从眼内抽出。将缝线环抽出，将缝线末端穿过环 4 次。两端缝线都被拉动，这会导致环在眼内滑动，从而使虹膜组织贴合，结位于后表面。
11 名患者的 11 只眼计划行内皮性角膜移植术，该手术在这些患者中进行。RFT 瞳孔成形术的前段光学相干断层扫描图像未显示前房或虹膜平面前表面有缝线存在。在整个随访期间，没有任何一只眼发生原发性移植物失功或排斥反应。
RFT 是一种在内皮性角膜移植术中行瞳孔成形术的有效技术，在前房内不会出现结或缝线尾。
