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眼内晶状体脱位病例报告中采用后路入路的改良矢野技术。

A modified Yamane technique with a posterior approach in a case report of intraocular lens dislocation.

作者信息

Iannetti Ludovico, Baratta Carmen, Figliola Flavia, Armentano Marta, Visioli Giacomo, Alisi Ludovico

机构信息

Ophthalmology Unit, Head and Neck Department, Policlinico Umberto I University Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; Department of Sense Organs, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.

Department of Sense Organs, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.

出版信息

Int J Surg Case Rep. 2025 Jun;131:111369. doi: 10.1016/j.ijscr.2025.111369. Epub 2025 Apr 25.

Abstract

INTRODUCTION

The Yamane intrascleral fixation technique is a widespread surgical approach used in ophthalmology to secure three-piece intraocular lenses (IOLs) without the use of sutures. This technique is particularly beneficial in cases where the capsular bag is not suitable for IOL implantation. By creating a flange at the tip of each haptic this procedure innovatively eliminates the need for additional securing materials. We report an alternative management of posterior intraocular lens (IOL) dislocation with a modified Yamane technique, performed in vitreous chamber.

CASE PRESENTATION

We describe the surgery of a 56-year-old male with posterior dislocation of the capsular bag and a three-piece IOL with Polymethylmethacrylate (PMMA) loops into the vitreous cavity. His medical history included retinal detachment treated with scleral buckling 40 years earlier and cataract surgery performed 4 years earlier. The patient underwent a 25-gauge pars plana vitrectomy. Scleral tunnels were created to externalize the PMMA loops and securing the IOL in a stable position according to the classic Yamane technique: a bimanual approach with a 30-gauge x 13 mm ultra-thin-walled needle and maxgrip forceps was used.

DISCUSSION

Modified Yamane technique performed in vitreous chamber, especially in selected cases of dislocated IOL with PMMA loops, may allow better handling of the IOL and the loop insertion. This modified technique, by reducing mechanical stress on the PMMA loops, contributes to long-term IOL integrity and lowers the risk of complications during surgery.

CONCLUSION

This technique may offer a reliable alternative for ophthalmic surgeons managing PMMA IOLs dislocations.

摘要

引言

山根巩膜内固定技术是眼科中广泛应用的一种手术方法,用于固定三件式人工晶状体(IOL),无需使用缝线。该技术在囊袋不适合植入人工晶状体的情况下特别有益。通过在每个襻的尖端制作一个凸缘,该手术创新性地消除了对额外固定材料的需求。我们报告了一种在玻璃体腔中采用改良山根技术治疗后房型人工晶状体(IOL)脱位的替代方法。

病例介绍

我们描述了一名56岁男性的手术情况,其囊袋后脱位,三件式人工晶状体的聚甲基丙烯酸甲酯(PMMA)襻进入玻璃体腔。他的病史包括40年前接受巩膜扣带术治疗视网膜脱离,以及4年前进行白内障手术。患者接受了25G经平坦部玻璃体切除术。根据经典的山根技术,制作巩膜隧道以使PMMA襻外置并将人工晶状体固定在稳定位置:采用30G×13mm超薄壁针和maxgrip镊子的双手操作方法。

讨论

在玻璃体腔中进行改良山根技术,特别是在选定的伴有PMMA襻的人工晶状体脱位病例中,可能会更好地处理人工晶状体和襻的插入。这种改良技术通过减少PMMA襻上的机械应力,有助于人工晶状体的长期完整性,并降低手术期间并发症的风险。

结论

该技术可能为眼科医生处理PMMA人工晶状体脱位提供一种可靠的替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/28cd/12056798/1a498518c567/gr1.jpg

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