虹膜损伤13例个性化修复术效果观察

The effect of personalized prosthetics on iris injury in 13 cases

目的：探讨虹膜损伤个性化修复方式的设计思路及手术技巧.方法：对13例（15眼）虹膜损伤的患者根据虹膜根部离断范围大小,酌情采用巩膜夹持法、双弯针聚丙烯缝线缝合法、注射针引线法、改良McCannal式、Siepser式虹膜缝合法修补虹膜.术后随访3个月,观察瞳孔形状、视力、眼压和角膜内皮细胞变化,有否单眼复视、畏光、眩光等不适症状.结果：术后3个月,裸眼视力优于0.5者11眼,0.1 ～0.4者4眼.患眼瞳孔呈圆形或类圆形,眼压正常,除Siepser式虹膜缝合法外,其余4种手术方法角膜内皮细胞丢失率在5.16％～26.57％,差异有统计学意义（P＜0.05）.患者无单眼复视、畏光、眩光等不适.结论：个性化虹膜损伤修复术,在提高视力的同时,能消除单眼复视、畏光、眩光等症状,提高视觉质量,达到损伤最小、视功能恢复最大的目的.

Objective： To explore the individual design and operation skill in repairing iris injury. Methods： Fifteen eyes in 13 patients were treated with selera clamping method, double curved needle polypropylene suture method, needle probe method, modified MeCannal style and Siepser style to suture iris according to the iridodialysis range, respectively. The pupil shape, vision, intraocular pressure,corneal endothelial cell change, monocular diplopia, sensitivity to light and glare in 13 cases were investigated during the period of following up for 3 months. Results ： The naked eye eyesight of 11 eyes and 4 eyes were more than or equal to 0.5 and O. 1 -0.4 in 3 months after operation, respectively. The pupils of patients were round or oval, their intraocular pressure was normal. Except Siepser style to suture iris ,the corneal endothelial cell loss rate in other four kinds of surgical methods were 5.16% to 26.57% , the difference of which had statistical significance （ P 〈 0.05 ）, there were not monocular diplopia, sensitivity to light and glare in patients. Conclusions： The individual prosthetics in repairing iris injury can improve eyesight, eliminate the symptoms of monocular diplopia,photophobia and glare and visual quality, which can achieve the purpose of minimum damage and maximum visual function recovery.