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视网膜脱离巩膜扣带术后缝线眼内侵入

Intraocular intrusion of sutures after retinal detachment buckling surgery.

作者信息

Weinberger D, Lichter H, Gaton D D, Kremer I, Axer-Siegel R, Yassur Y

机构信息

Department of Ophthalmology, Beilinson Medical Center, Petah Tiqva, Israel.

出版信息

Retina. 1995;15(5):417-21. doi: 10.1097/00006982-199515050-00008.

Abstract

BACKGROUND

Intraocular intrusion of tight encircling silicone band is a major complication of retinal detachment surgery leading to subretinal and vitreous hemorrhage, retinal detachment, and phthisis bulbi. Intrusion of the sutures into the eye has only been reported as an adjunct to buckle intrusion.

METHODS

Seven patients (9 eyes) are presented in whom intrusion of sutures occurred as a late complication of retinal detachment surgery using the extrascleral buckling technique. Their complications and treatments are discussed.

RESULTS

Eleven anchoring sutures were observed under the retina and two sutures penetrated into vitreous cavity. In five eyes (55.5%), small subretinal or vitreous hemorrhages were noted and in one of them perforation with total detachment occurred. In four eyes, no complications were detected. In four eyes, the silicone band was cut and left in place and the hemorrhages were spontaneously absorbed. The perforated eye underwent replacement of the silicone band with a wide silicone sponge, followed by vitrectomy and silicone oil injection.

CONCLUSIONS

Intrusion of sutures into the eye can rarely be seen years after retinal detachment surgery and usually do not require surgical intervention. When hemorrhage occurs, cutting of the silicone band only, with no attempt to remove the band or the sutures, is recommended.

摘要

背景

紧密环绕的硅胶带眼内侵入是视网膜脱离手术的一种主要并发症,可导致视网膜下和玻璃体出血、视网膜脱离以及眼球痨。缝线侵入眼内仅作为扣带侵入的一种辅助情况被报道过。

方法

本文报告了7例患者(9只眼),缝线侵入是使用巩膜外扣带技术进行视网膜脱离手术后的一种晚期并发症。对其并发症及治疗情况进行了讨论。

结果

在视网膜下观察到11根固定缝线,2根缝线穿透进入玻璃体腔。5只眼(55.5%)出现了小的视网膜下或玻璃体出血,其中1只眼发生了穿孔并伴有完全性视网膜脱离。4只眼未检测到并发症。4只眼中,硅胶带被切断并留在原位,出血自行吸收。穿孔眼用宽硅胶海绵替换硅胶带,随后进行玻璃体切除术并注入硅油。

结论

视网膜脱离手术后数年很少能见到缝线侵入眼内的情况,通常不需要手术干预。当发生出血时,建议仅切断硅胶带,而不试图移除带或缝线。

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