Ferro Desideri Lorenzo, Arun Kirupakaran, Doherty Grace, Bernardi Enrico, Anguita Rodrigo
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.
J Clin Med. 2024 May 4;13(9):2706. doi: 10.3390/jcm13092706.
: 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.
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。