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虹膜重建:外科医生指南。

Iris Reconstruction: A Surgeon's Guide.

作者信息

Ferro Desideri Lorenzo, Arun Kirupakaran, Doherty Grace, Bernardi Enrico, Anguita Rodrigo

机构信息

Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 15, CH-3010 Bern, Switzerland.

Department for BioMedical Research, University of Bern, Murtenstrasse 24, CH-3008 Bern, Switzerland.

出版信息

J Clin Med. 2024 May 4;13(9):2706. doi: 10.3390/jcm13092706.

DOI:10.3390/jcm13092706
PMID:38731235
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11084487/
Abstract

: The aim of this review paper is to summarise surgical options available for repairing iris defects at the iris-lens plane, focusing on suturing techniques, iridodialysis repair, and prosthetic iris devices. : A thorough literature search was conducted using multiple databases, including Medline, PubMed, Web of Science Core Collection, and the Cochrane Library, from inception to February 2024. Relevant studies were screened based on predefined criteria, and primary references cited in selected articles were also reviewed. : Various surgical techniques were identified for iris defect repair. Suturing methods such as interrupted full-thickness sutures and the McCannel technique offer solutions for smaller defects, while iridodialysis repair techniques address detachment of the iris from the ciliary body. Prosthetic iris devices, including iris-lens diaphragm devices, endocapsular capsular tension ring-based devices, and customizable artificial iris implants, provide options for larger defects, each with its own advantages and limitations. : Successful iris reconstruction requires a personalised approach considering factors like defect size, ocular comorbidities, and patient preference. Surgeons must possess a thorough understanding of available techniques and prosthetic devices to achieve optimal outcomes in terms of both visual function and, nonetheless, cosmetic appearance.

摘要

本文综述的目的是总结在虹膜 - 晶状体平面修复虹膜缺损的可用手术选择,重点关注缝合技术、虹膜根部离断修复和人工虹膜装置。

使用多个数据库进行了全面的文献检索,包括Medline、PubMed、科学网核心合集和Cochrane图书馆,检索时间从建库至2024年2月。根据预定义标准筛选相关研究,并对所选文章中引用的主要参考文献进行了审查。

已确定多种用于修复虹膜缺损的手术技术。间断全层缝合和麦坎内尔技术等缝合方法为较小的缺损提供了解决方案,而虹膜根部离断修复技术则用于处理虹膜与睫状体的分离。人工虹膜装置,包括虹膜 - 晶状体隔膜装置、基于囊袋内囊袋张力环的装置和可定制的人工虹膜植入物,为较大的缺损提供了选择,每种装置都有其自身的优缺点。

成功的虹膜重建需要一种个性化的方法,考虑缺损大小、眼部合并症和患者偏好等因素。外科医生必须全面了解可用技术和人工装置,以便在视觉功能和外观方面都能取得最佳效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebd3/11084487/89990f477d81/jcm-13-02706-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebd3/11084487/ce68062953a2/jcm-13-02706-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebd3/11084487/89990f477d81/jcm-13-02706-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebd3/11084487/ce68062953a2/jcm-13-02706-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebd3/11084487/89990f477d81/jcm-13-02706-g002.jpg

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Iris Reconstruction: A Surgeon's Guide.虹膜重建:外科医生指南。
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2
Iris reconstruction: A perspective on the modern surgical armamentarium.虹膜重建:现代手术器械库的视角
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Indian J Ophthalmol. 2018 Aug;66(8):1169-1176. doi: 10.4103/ijo.IJO_1320_17.
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Iris reconstruction suturing techniques.虹膜重建缝合技术。
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Prosthetic iris devices.人工虹膜装置
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Suturing repair of subtotal iridodialysis.虹膜根部离断的缝合修复术
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Iris reconstruction using autologous iris preserved in cold balanced salt solution for 8 hours in iatrogenic total iridodialysis during cataract surgery: a case report.白内障手术医源性全虹膜根部断离时使用在冷平衡盐溶液中保存8小时的自体虹膜进行虹膜重建:1例病例报告
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Traumatic Iris Reconstruction外伤性虹膜重建

引用本文的文献

1
Novel Surgical Approach for Aphakia and Iridodialysis: Artificial Iris and Scleral-Fixated Lens as a Single Complex.无晶状体眼和虹膜根部离断的新型手术方法:人工虹膜和巩膜固定晶状体作为一个单一复合体
J Clin Med. 2025 Feb 27;14(5):1599. doi: 10.3390/jcm14051599.
2
Thirty-gauge needle-guided purse-string suture pupilloplasty: a new technique.30号针引导荷包缝合瞳孔成形术:一种新技术。
Int J Ophthalmol. 2024 Dec 18;17(12):2327-2332. doi: 10.18240/ijo.2024.12.23. eCollection 2024.

本文引用的文献

1
Cosmetic iris implants - double edge sword.
Eur J Ophthalmol. 2023 Nov;33(6):2062-2067. doi: 10.1177/11206721231160989. Epub 2023 Feb 27.
2
Novel surgical technique of sutureless artificial iris and intraocular lens scleral fixation using Yamane technique.使用山根技术的无缝线人工虹膜和人工晶状体巩膜固定术的新型手术技术。
Am J Ophthalmol Case Rep. 2022 Mar 25;26:101502. doi: 10.1016/j.ajoc.2022.101502. eCollection 2022 Jun.
3
Iridodialysis repair - A simplified approach.虹膜根部离断修复——一种简化的方法。
Indian J Ophthalmol. 2022 Mar;70(3):1073. doi: 10.4103/ijo.IJO_428_22.
4
Iris and Lens Trauma - Iris Reconstruction.
Klin Monbl Augenheilkd. 2020 Sep;237(9):1079-1086. doi: 10.1055/a-1217-1199. Epub 2020 Sep 23.
5
Management of common iatrogenic iris defects induced by cataract surgery.白内障手术后常见医源性虹膜缺损的处理。
J Cataract Refract Surg. 2021 Apr 1;47(4):522-532. doi: 10.1097/j.jcrs.0000000000000411.
6
Aesthetics of iris reconstruction with a custom-made artificial iris prosthesis.定制人工虹膜假体进行虹膜重建的美学评估。
PLoS One. 2020 Aug 13;15(8):e0237616. doi: 10.1371/journal.pone.0237616. eCollection 2020.
7
Safety and efficacy of custom foldable silicone artificial iris implantation: prospective compassionate-use case series.定制可折叠硅胶人工虹膜植入的安全性和有效性:前瞻性同情使用病例系列。
J Cataract Refract Surg. 2020 Jun;46(6):893-901. doi: 10.1097/j.jcrs.0000000000000172.
8
Iris reconstruction suturing techniques.虹膜重建缝合技术。
Curr Opin Ophthalmol. 2020 Jan;31(1):43-49. doi: 10.1097/ICU.0000000000000628.
9
Pupil cerclage technique for treatment of traumatic mydriasis.瞳孔环扎术治疗外伤性瞳孔散大
Eur J Ophthalmol. 2020 May;30(3):480-486. doi: 10.1177/1120672119839304. Epub 2019 Apr 7.
10
Single-Pass Four-Throw Pupilloplasty Knot Mechanics.单通道四抛瞳孔成形术的结力学
J Refract Surg. 2019 Mar 1;35(3):207-208. doi: 10.3928/1081597X-20190125-01.