改良虹膜环扎术治疗青光眼术后永存瞳孔散大

Modified iris cerclage to treat permanent mydriasis in patients under going glaucoma surgery

本文主要介绍1例急性闭角型青光眼大发作后的患者,经过小梁切除及虹膜周边切除术,并二期行白内障超声乳化联合人工晶状体植入,术后残存瞳孔散大出现畏光不适等症状,通过改良虹膜环扎术进行治疗.手术要点主要是通过做4个角膜缘透明切口,将虹膜分为4段进行环扎缝合,根据瞳孔形态和虹膜周切口的位置调整缝线松紧后打结.术后效果良好,瞳孔外形呈类圆形,也避免了因虹膜周边切口被牵拉至角膜中央区致双瞳孔现象.

This paper describes modified iris cerclage for the treatment of a patient who had undergone trabeculectomy combined with peripheral iridectomy for glaucoma and phacoemulsification combined with intraocular lens implantation for cataract one year later.The key points of the surgery involve making four transparent incisions at the corneal margin,dividing the iris into four segments for encircling sutures,and adjusting the tension of the sutures based on the shape of the pupil and the position of the iris incisions before knotting.The postoperative outcomes were satisfactory,with the pupil's shape being nearly circular.The appearance of double pupils was avoided.