外伤性睫状体脱离小瘘口的检查方法及手术复位  

Cyclopexy secondary to traumatic cyclodialysis cleft

作　　者：王建洲[1] 崔海龙[1] 许治国[1] 宋虎平[1] 张倩[1] 陈洁[1] 张智俊[1] 刘亚茹[1] 

机构地区：[1]西安市第四医院眼科,陕西省西安市710004

出　　处：《眼科新进展》2011年第12期1148-1150,共3页Recent Advances in Ophthalmology

基　　金：西安市科学基金资助项目(编号:YF07140)~~

摘　　要：目的探讨外伤性睫状体脱离小瘘口的检查与定位方法及手术复位的临床效果。方法 15例外伤性睫状体脱离患者经房角镜结合UBM检查以及缩瞳结合UBM检查,准确定位瘘口,根据瘘口的部位和范围选择手术方式,手术采取睫状体冷凝术与睫状体缝合术进行治疗。结果 15例外伤性睫状体脱离患者,均为360°的睫状体脱离。5例缩瞳后结合UBM检查发现隐匿的较小瘘口,其余均经房角镜结合UBM发现瘘口,且瘘口均小于1个钟位,其中,4例行单纯睫状体冷凝术,使睫状体复位,其余11例中5例先行睫状体冷冻术,后行睫状体缝合术,6例直接行单纯睫状体缝合术。术后视力不同程度提高,术后6眼一过性眼压升高,1眼术后1个月时眼压超过正常水平。结论定位和封闭瘘口是睫状体脱离手术的目的和关键,瘘口的准确定位能较大程度地缩小手术范围。同时全面的缩瞳结合UBM检查,对于可疑瘘口的发现非常必要。[眼科新进展2011;31(12):1148-1150]Objective To investigate the detection,location and clinical effect of cyclopexy for traumatic cyclodialysis.Methods Fifteen cases（15 eyes） with traumatic cyclodialysis were undergone cyclopexy（cyclo-suture and cyclo-coagulation） by ultrasound biomicroscopy（UBM） combined with gonioscoy and myosis in order to finding cyclodialysis clefts.The operative method was selected according to position and extent of cyclodialysis cleft.Cyclocryosurgery and ciliary body suture were used for treatment.Results Fifteen cases with traumatic cyclodialysis were 360° cylodialysis.Myosis combined with UBM showed occult cyclodialysis cleft,and cyclopexy was found by gonioscope.The cleft amplitude is smaller than one o＇clock.Among all cases,4 cases were undergone cyclo-coagulation,and 6 cases were done by direct cyclo-suture,and 5 cases did by cyclo-coagulation first and then did by cyclo-suture.No residual cleft was identified in UBM,and visual acuity improved except for one cases combined with traumatic neuroretinopathy.After operation,transcent intraocular pressure increased in 6 eyes,and 1 eye of which was higher than normal level at postoperative 1 month.Conclusions It is not crucial the cyclodialysis limiting but the cyclodialysis cleft,and through the accurate location of cleft in large extent diminution surgical amplitude.And it is essential of full-scale examination combined with myosis for finding occult cyclolysis cleft.

关 键 词：外伤性睫状体脱离 小瘘口 隐匿瘘口 睫状体复位手术 缩瞳 房角镜 超声生物显微镜 

分 类 号：R773.3[医药卫生—眼科]