Shah Arjav, Kanter Jacob A, Eisengart Jonathan, Blieden Lauren S, Qiu Mary
Department of Ophthalmology and Visual Science, University of Chicago, 5758 S. Maryland Ave, Suite 1B, Chicago, IL, 60637, USA.
Wilmer Eye Institute, Johns Hopkins University, 1800 Orleans St, Baltimore, MD, 21287, USA.
Am J Ophthalmol Case Rep. 2024 Feb 28;34:102009. doi: 10.1016/j.ajoc.2024.102009. eCollection 2024 Jun.
Tube shunts can be inserted into the anterior chamber, ciliary sulcus, or pars plana. Sulcus tube placement can be challenging. This report demonstrates three techniques for guidewire-assisted sulcus tube insertion.
The first technique uses a needle inserted through a paracentesis 180-degrees across from the tube entry site and creates an ab-interno sclerotomy through which the guidewire is inserted by docking it into the needle bevel. The second technique involves inserting the guidewire into the eye via a paracentesis and using microforceps to retrieve it through a sclerotomy. The third technique uses forceps to insert the guidewire into a paracentesis 180° across from the planned tube entry site and dock it into a needle bevel that has been inserted into the sulcus. Each of these techniques provides a reliable and reproducible way to insert a tube into the sulcus.
Guidewire-assisted tube entry offers a promising solution in cases of difficult sulcus tube placement without substantial additional cost.
引流管可植入前房、睫状沟或睫状体扁平部。睫状沟引流管植入可能具有挑战性。本报告展示了三种导丝辅助下睫状沟引流管植入技术。
第一种技术是通过在距引流管置入部位180度的位置进行穿刺，插入一根针，然后通过针斜面将导丝对接插入，从而在内面进行巩膜切开术。第二种技术是通过穿刺将导丝插入眼内，然后用微型镊子通过巩膜切开术将其取出。第三种技术是用镊子将导丝插入距计划的引流管置入部位180°的穿刺孔中，并将其对接插入已插入睫状沟的针斜面。这些技术中的每一种都提供了一种可靠且可重复的方法，将引流管植入睫状沟。
在睫状沟引流管植入困难的情况下，导丝辅助引流管置入提供了一种有前景的解决方案，且无需大幅增加成本。
