Fraunfelder F T, Boozman F W, Wilson R S, Thomas A H
Arch Ophthalmol. 1977 Sep;95(9):1616-20. doi: 10.1001/archopht.1977.04450090138012.
Large variations in intraocular pressure occur during enucleation, scleral depression, 32P testing, and vigorous rubbing of an eye. Data from animal studies show that during a critical phase of an intraocular malignant melanoma, ocular massage significantly decreased longevity due to increased metastastic disease. We report "no-touch" technique to prevent tumor spread from occurring secondary to ocular manipulation during enucleation. This technique avoids IOP elevations above 50 mm Hg before freezing completely around the tumor, thereby preventing flow of fluid and blood to or from the tumor prior to the manipulation necessary for enucleation. Theoretically, the patient with an ocular tumor should be warned against vigorous rubbing of his eyes and hard lid squeezes or diagnostic techniques that elevate IOP. The ophthalmologist should perform enucleation with gentieness and avoid pressure on the globe. Patients who are being followed up with a suspected ocular tumor should be warned not to rub or vigorously squeeze their eyelids.
眼球摘除、巩膜压迫、32P检测以及用力揉眼过程中眼压会出现大幅波动。动物研究数据表明，在眼内恶性黑色素瘤的关键阶段，眼部按摩会因转移性疾病增加而显著缩短生存期。我们报告一种“无接触”技术，以防止眼球摘除过程中因眼部操作继发肿瘤扩散。该技术可避免在肿瘤完全冷冻之前眼压升高超过50 mmHg，从而在眼球摘除所需操作之前防止液体和血液流入或流出肿瘤。理论上，应告诫患有眼肿瘤的患者不要用力揉眼、用力挤压眼睑或采用会升高眼压的诊断技术。眼科医生进行眼球摘除时应轻柔操作，避免对眼球施压。对疑似眼肿瘤进行随访的患者应被告知不要揉眼或用力挤压眼睑。
