中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2011年
11期
1134-1135
,共2页
浅前房%缝线%超声乳化联合小梁切除%青光眼
淺前房%縫線%超聲乳化聯閤小樑切除%青光眼
천전방%봉선%초성유화연합소량절제%청광안
Glaucoma%Suture%Shallow anterior chamber%Trabeculectomy and phacoemulsification
目的 探讨超声乳化人T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.
目的 探討超聲乳化人T晶狀體植入聯閤小樑切除術中鞏膜瓣縫線鬆緊度調整預防術後淺前房的作用.方法 41例46隻眼,行常規超聲乳化人工晶狀體植入聯閤小樑切除.縫閤鞏膜瓣,註水形成前房,模擬眨眼輕觸顳側角鞏緣,如果前房消失或變淺,則說明縫線過鬆,重新縫閤鞏膜瓣或增加縫線,再註水形成前房,輕觸角鞏緣,前房存在；繼續前房註水,同時觸踫眼毬,感到眼毬硬；棉籤檫榦瓣邊緣,見滲水少；說明縫線過緊；可用細針頭輕挑鞏膜床針眼,使針眼變大,縫線相應變鬆,再停註水,輕踫眼毬,前房不變淺,說明縫線不過鬆；前房註水同時觸眼毬不硬,說明縫線不過緊.結果 二隻眼術後第二天齣現淺前房.一隻眼鞏膜瓣偏薄,小樑切口偏後,縫緊鞏膜瓣前房形成.一例高齡女性,房水分泌少,重縫小樑切口,前房形成.其餘患者術後均未齣現淺前房.結論 鞏膜瓣縫閤前房註入形成後,通過輕觸眼毬,模擬眼毬活動時的狀態,觀察前房是否明顯變淺,從而調整縫線的鬆緊度或數量,使前房穩定.這種方法能有效地減少術後淺前房的髮生.
목적 탐토초성유화인T정상체식입연합소량절제술중공막판봉선송긴도조정예방술후천전방적작용.방법 41례46지안,행상규초성유화인공정상체식입연합소량절제.봉합공막판,주수형성전방,모의잡안경촉섭측각공연,여과전방소실혹변천,칙설명봉선과송,중신봉합공막판혹증가봉선,재주수형성전방,경촉각공연,전방존재；계속전방주수,동시촉팽안구,감도안구경；면첨찰간판변연,견삼수소；설명봉선과긴；가용세침두경도공막상침안,사침안변대,봉선상응변송,재정주수,경팽안구,전방불변천,설명봉선불과송；전방주수동시촉안구불경,설명봉선불과긴.결과 이지안술후제이천출현천전방.일지안공막판편박,소량절구편후,봉긴공막판전방형성.일례고령녀성,방수분비소,중봉소량절구,전방형성.기여환자술후균미출현천전방.결론 공막판봉합전방주입형성후,통과경촉안구,모의안구활동시적상태,관찰전방시부명현변천,종이조정봉선적송긴도혹수량,사전방은정.저충방법능유효지감소술후천전방적발생.
Objective To investigate the effect of adjusting sutures in reducing the occurrence of shallow or flat anterior chamber after trabeculectomy and phacoemulsification.Methods Forty one patients 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 chamber became significantly shallow,it was necessary to tighten or add more sutures.Results On postoperative 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 tighmess of the sutures therefore reduce the occurrence of shallow anterior chamber.
