Pham D T, Anders N, Wollensak J
Augenklinik im Virchow-Klinikum der Humboldt-Universität zu Berlin.
Klin Monbl Augenheilkd. 1996 Feb;208(2):124-6. doi: 10.1055/s-2008-1035183.
Wound strength of the self-sealing tunnel technique is much higher than the former sutured corneoscleral incision, as many experimental investigations have shown. Therefore only a few cases of traumatic wound rupture after tunnel incision are published. We report on a traumatic wound rupture with loss of the IOL with capsular bag and iris.
An 80-year-old patient suffered a traumatic wound rupture one year after cataract surgery with a 7-mm scleral self-sealing wound construction. The IOL with capsular bag and iris were expulsed and the wound construction was damaged. By gonioscopy a large irregular lesion of the inner lamella could be observed. After pars plana vitrectomy of the severe vitreous hemorrhage a visual acuity of 0.5 was achieved. The mechanism of the wound rupture is discussed.
The loss of the iris and the IOL and the lesion of the inner lamella suggest a massive force. The yet existing relative wound stability after the trauma depends on the still working self-sealing mechanism of the tunnel construction in spite of the lesion of the inner lamella.
正如许多实验研究所表明的那样,自密封隧道技术的伤口强度远高于先前的缝合式角巩膜切口。因此,关于隧道切口后创伤性伤口破裂的病例报道很少。我们报告一例伴有人工晶状体、囊袋和虹膜脱出的创伤性伤口破裂病例。
一名80岁患者在接受白内障手术并采用7毫米巩膜自密封伤口构建术后一年,发生了创伤性伤口破裂。人工晶状体、囊袋和虹膜脱出,伤口结构受损。通过前房角镜检查可观察到内层有一个大的不规则病变。在对严重玻璃体积血进行玻璃体切除术后,视力达到了0.5。本文讨论了伤口破裂的机制。
虹膜和人工晶状体的脱出以及内层的病变提示存在巨大外力。尽管内层有病变,但创伤后仍存在的相对伤口稳定性取决于隧道结构仍在起作用的自密封机制。