超声乳化人工晶状体植入联合小梁切除调整巩膜瓣缝线预防浅前房  

The effect of adjusting sutures in reducing the occurrence of shallow or flat anterior chamber after trabeculectomy and phacoemulsification

作　　者：赵东升[1] 祝肇荣[1] 

机构地区：[1]上海交通大学医学院附属新华医院眼科,上海200092

出　　处：《中国实用眼科杂志》2011年第11期1134-1135,共2页Chinese Journal of Practical Ophthalmology

基　　金：基金项目：上海市重点学科建设项目资助（$30205）

摘　　要：目的探讨超声乳化人工晶状体植入联合小梁切除术中巩膜瓣缝线松紧度调整预防术后浅前房的作用。方法41例46只眼，行常规超声乳化人工晶状体植入联合小梁切除。缝合巩膜瓣，注水形成前房，模拟眨眼轻触颞侧角巩缘，如果前房消失或变浅，则说明缝线过松，重新缝合巩膜瓣或增加缝线，再注水形成前房，轻触角巩缘，前房存在；继续前房注水，同时触碰眼球，感到眼球硬；棉签檫干瓣边缘，见渗水少；说明缝线过紧；可用细针头轻挑巩膜床针眼，使针眼变大，缝线相应变松，再停注水，轻碰眼球，前房不变浅，说明缝线不过松；前房注水同时触眼球不硬，说明缝线不过紧。结果二只眼术后第二天出现浅前房。一只眼巩膜瓣偏薄，小梁切口偏后，缝紧巩膜瓣前房形成。一例高龄女性，房水分泌少，重缝小梁切口，前房形成。其余患者术后均未出现浅前房。结论巩膜瓣缝合前房注入形成后，通过轻触眼球，模拟眼球活动时的状态，观察前房是否明显变浅，从而调整缝线的松紧度或数量，使前房稳定。这种方法能有效地减少术后浅前房的发生。Objective To investigate the effect of adjusting sutures in reducing the occurrence of shallow or fiat anterior chamber after trabeculectomy and phacoemulsification. Methods Forty one pa- tients had undergone trabeculectomy and phacoemulsification with intraocular lens implantation. After suturing the scleral flap, reinfusion of the anterior chamber was carried out. Then the limbus received gently touching to mimic the press caused by blinking of the eyelids to the eye. If the anterior cham- ber became significantly shallow, it was necessary to tighten or add more sutures. Results On post- operative day one, shallow anterior chamber occurred in two eyes, which was addressed effectively by adding more sutures to the scleral flap. Conclusions Gently touching the limbus to mimic the press caused by blinking allow the surgeons to adequately evaluate and adjust the tightness of the sutures therefore reduce the occurrence of shallow anterior chamber.

关 键 词：浅前房 缝线 超声乳化联合小梁切除 青光眼 

分 类 号：R779.66[医药卫生—眼科]