改进的灌注导管头在玻璃体手术中的应用

Application of a modified infusion cannula in vitrectomy

目的:使用一种更加稳定的玻璃体手术灌注导管头,以预防灌注导管头对晶状体的损伤。方法:将常规玻璃体手术用4mm长灌注导管头的柄弯成135°夹角,方向与固定翼垂直,针头斜面与柄的弯曲方向相反。按玻璃体手术常规插入灌注导管头并用7-0可吸收缝线固定灌注导管头的两翼。术中通过压陷巩膜方法观察灌注导管头的位置及附近眼内组织的情况。结果:连续36只有晶状体眼使用了这种改进的灌注导管头。术中发现,与常规灌注导管头相比,弯灌注导管头能更稳定地附在眼球表面,在眼球转动时灌注导管头摆动幅度小,特别是在取放接触镜时不会因误压灌注导管头引起针头向前翘起损伤晶状体。没有发现灌注导管头进入脉络膜上腔、损伤晶状体和视网膜病例。术后随访未发现与灌注导管头有关的视网膜裂孔和脱离。结论:在有晶状体眼使用改进后的弯灌注导管头更加安全,效果更好。

AIM： To evaluate the effect of a modified infusion cannula to avoid lens injury in vitrectomy surgery. METHODS： The handle of a standard 4mm infusion cannula was bent into a 135° angle, and cannula was at right angle to the fixed-wing of the infusion cannula. The oblique plane of the needle had a direction opposite to the bending angle of the handle. Infusion cannula was inserted into the eye and fixed with 7-0 self-absorbed suture, and cannula and intraocular tissue were observed with indentation of the sclera during vitrectomy. RESULTS： A total of 36 phakic eyes underwent vitreoretinal procedures by using the infusion cannula. It was observed that the modified infusion cannula was more stable and had less possibility to injure lens than conventional infusion cannula during the surgery, especially when taking or placing contact lens. No relevant complications, such as entry of cannula into suprachoroidal space, lens injury or retinal detachment, were observed. CONCLUSION： Modified infusion cannula is a safer and more effective method in phakic vitrectomy surgery.