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周围虹膜切除术在脑内眼内镜片固定:防止反向瞳孔阻塞

Fikret Ucar¹, Muhammed Sagdic²

¹From the Department of Ophthalmology (F.U.), Konyagoz Eye Hospital, Konya, Turkey.

American journal of ophthalmology

|October 12, 2024

概括

在内透镜固定手术期间进行外科外围虹膜切除术可以减少反向瞳孔阻塞 (RPB) 和并发症. 激光外周 iridotomy (LPI) 有效地管理了手术后的 RPB.

科学领域:

眼科医生眼科眼科
手术创新在外科创新.
眼内透镜植入眼内透镜植入

背景情况:

无内内眼镜 (IOL) 固定是玻璃体脱位IOL的常见程序.
反向瞳孔阻塞 (RPB) 是此类手术后的潜在并发症.
术内外围皮膜切除术在缓解RPB和改善结果方面的作用尚未完全确定.

研究的目的:

为了比较临床结果,RPB发病率和前段参数,在经历了术内外围虹膜切除术的患者中进行内外围虹膜修复.
评估外周虹膜切除术对前腔深度 (ACD),前腔角度 (ACA) 和眼内压力 (IOP) 的影响.

主要方法:

94只眼睛 (82名患者) 的回顾性比较病例系列,接受了IOL扩张和通过帕斯普拉纳视切除术进行内内固定.
患者被分为两组:第1组 (n=54) 进行了手术内外围虹膜切除术,第2组 (n=40) 没有.
前段参数 (ACD,ACA) 使用Scheimpflug成像进行测量.

主要成果:

术后的ACD在第一组 (3.79毫米) 与第二组 (4.11毫米) 相比显著较浅 (P=.03).
在第一组 (15.51 mm Hg) 的术后内血压明显低于第二组 (18.20 mm Hg) (P<.001).
在第二组眼睛中,RPB发生在25%的眼睛中,但在第一组眼睛中没有 (P<.001). 在第二组中,瞳孔捕获也发生了.
激光外周 iridotomy (LPI) 在管理RPB是有效的,导致IOP,ACA和ACD显著减少.

结论:

在帕斯普拉纳视切除术 (pars plana vitrectomy) 进行内固定手术期间的外科外围视切除术与减少RPB发生率和更少的并发症有关.
外周虹膜切除术有助于更稳定的前腔和较低的术后IOP.
当LPI发生时,LPI是管理术后RPB的一个有价值的工具.

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