白内障手术致虹膜根部断离原因及修复方法的探讨  

Apporach to the causes and repair of iridodiastasis in cataract surgery

作　　者：廖志敏[1] 

机构地区：[1]南阳医学高等专科学校附属医院眼科,河南南阳473058

出　　处：《眼外伤职业眼病杂志》2008年第5期361-363,共3页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的探讨手法小切口白内障手术操作过程中,导致虹膜根部断离的原因和修复手术方法。方法手法小切口白内障手术560例(560眼)中出现术中虹膜根部断离≥60°者有18例(18眼),占3.21%。处理方法是在虹膜根部断离区域作以穹隆为基底的结膜瓣,角膜缘切口,利用黏弹剂进行根部断离虹膜推移,Ⅰ期手术缝合固定。结果分析术中发生虹膜根部断离的原因:与作巩膜隧道切口有关者2眼(11.11%)与进出眼内器械有关者2眼(11.11%),与娩核有关者8眼(44.44%),与人工晶状体植入有关者1眼(5.56%),清除皮质时误吸虹膜造成者5眼(27.78%)。经显微手术修复,术后视力≥0.5者16眼(88.89%),≤0.2者2眼(11.11%)。均避免了双瞳孔及影响视功能的因素。结论手术中操作不当,技术不够娴熟是造成术中虹膜根部断离的主要原因。而及时发现,积极妥善修复是关键。Objective To discuss the causes and repair of iri-dodiastasis occurred during the minor incision extaction of cataracts. Methods Eighteen patients （ 18 eyes） equals to 3.21% had iridodiastasis more than 60° due to the minor incision extraction of cataracts which we operated on 560 patients （560 eyes）. We used the incision of the sclera tunnel and the hinder to move iris,in order to fix iris. All of them had primary repaired. Results The causes of iridodiastasis were discussed：2 case were realated to the incision of the sclera tunnel （11.11%） , 2 ease were realated to the apparatuses in the surgery （11.11%） , 8 case were realated to the extraction of the nuclear（44.44% ） ,5 case were realated to the error in the suck of cortical （27.78%） , l case were realated to the implantation of artificial lens （5.56%）. After the microscopic repaired, 16 patients ,VA≥0.5 （88.89%） , 2 patients,VA≤0.2 （11. 11% ）. Monocular diplopia and other severe complications were avoid. Conclusions Inappropriate operation and inexperience are the main cause of iridodiastasis. The sticking point to handle it is to discover and repair it in time.

关 键 词：白内障手术 虹膜根部断离 原因 修复 

分 类 号：R779.66[医药卫生—眼科]