闭合式微创虹膜根部离断缝合手术效果观察  

The efficacy of closed micro-invasive surgery for repair iridodiastasis

作　　者：范军华 吴涵 Fan Junhua;Wu Han(Department of Ophthalmology,Xiang'an Hospital of Xiamen University,Eye Institute of Xiamen University,Xiamen,Fujian 361102,China)

机构地区：[1]厦门大学附属翔安医院眼科厦门大学眼科研究所,361102

出　　处：《临床眼科杂志》2022年第2期156-158,共3页Journal of Clinical Ophthalmology

摘　　要：目的探讨虹膜根部离断手术缝合治疗的新方法,并评价其疗效。方法前瞻性病例研究。将带双长针的10-0聚丙烯缝线的缝针略折成弧形,在靠近虹膜离断处的角膜旁中央区斜刺入前房,针尖挑起虹膜断缘,轻压针尾,使针尖连同虹膜断缘翘起并推向睫状沟,针尖穿过虹膜断缘,经睫状沟从角膜缘后约1.5 mm处巩膜面出针。第二针从第一针形成的角膜针孔进入前房,同样方法褥式缝合虹膜断缘后从角膜缘后1.5 mm处巩膜面出针并打结。如此反复可从同一针眼继续缝合离断的虹膜。4例虹膜根部离断的患者采取此方法进行虹膜根部修复手术,术后观察虹膜根部复位情况及瞳孔形态。结果4例患者手术后虹膜根部离断得到完全修复,消除了双瞳孔征、瞳孔移位、复视等症状。结论全闭合式微创虹膜根部离断缝合手术操作简单、创伤小,极大降低了发生手术并发症的机率,术后效果良好,值得推广应用。Objective To introduce a new method for repair iridodialysis and evaluate its efficacy.Methods Retrospectrive case study.The double-armed 10-0 polypropylene suture needle is taken,then gently bent the middle of the needle to form an arc with slightly curve shape.The arc needle was obliquely punctured into the anterior chamber at the peripheral cornea where closed to the broken iris root.Then lifted the broken margin of iris at the suture point by the tip of the needle and pushed into the ciliary sulcus.Finally,the suture needle has pierced the root of the iris and passed at the sclera from 1.5 mm posterior to the limbus.The second needle inserted into the anterior chamber through the corneal pinhole formed by the first needle,then the needle tip passed through the iris broken margin and sclera about 1.5 mm from the previous needle by mattress-suture.Tighten the suture and tied a knot with the ends on the sclera,then transfer the knot into the scleral matrix.This repetition allows the broken iris to be sutured from the same pinhole.4 patients with iridodialysis were treated with this method,postoperative iris root recovery and pupil morphology were observed.Results The iridodialysis was completely repaired after surgery in 4 patients,and the symptoms such as dicoria,pupillary shift,and diplopia were eliminated.Conclusions This closed minimally invasive operation of iridodialysis is simple and less invasive,which greatly reduces surgical complications.The postoperative efficacy is good and it is worthy of popularization and application.

关 键 词：虹膜根部离断 显微手术 前房闭合式 微创 

分 类 号：R779.6[医药卫生—眼科]