Guasch Fernando Martinez, Thompson Ryan, Oula Desai, Ward Sarah, Levin Moran Roni, Alexander Janet Leath
Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland.
Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland.
J AAPOS. 2025 Feb;29(1):104105. doi: 10.1016/j.jaapos.2025.104105. Epub 2025 Jan 22.
We report the use of the Harms trabeculotome to facilitate 360° microcatheter advancement during illuminated microcatheter-assisted circumferential trabeculotomy (IMCT) ab externo in a 3-month-old infant with bilateral primary congenital glaucoma who required repeat surgery. The illuminated microcatheter was advanced 270°, from 9 to 6 o'clock; however, a focal blockage occurred, and, despite viscodilation, further advancement was not possible. The surgeon introduced a right Harms trabeculotome in the opposite direction, counterclockwise through the same scleral flap. The trabeculotome approximated and manipulated the illuminated microcatheter tip. The illuminated microcatheter was then able to advance beyond the focal obstruction, and the 360° circumferential trabeculotomy was completed.
我们报告了在一名3个月大、患有双侧原发性先天性青光眼且需要再次手术的婴儿中，使用哈姆斯小梁刀在照明微导管辅助外路环形小梁切开术（IMCT）期间促进360°微导管推进的情况。照明微导管从9点至6点方向推进了270°；然而，出现了局部阻塞，尽管进行了粘弹扩张，仍无法进一步推进。外科医生通过同一个巩膜瓣以逆时针方向在相反方向插入一把右侧哈姆斯小梁刀。小梁刀靠近并操作照明微导管尖端。然后照明微导管能够推进至局部阻塞部位之外，从而完成了360°环形小梁切开术。
