虹膜扩张器在小瞳孔白内障手术中的应用

IRIS DILATOR IN APPLICATION OF SMALL PUPIL CATARACT SURGERY

目的探讨虹膜扩张器在瞳孔粘连和瞳孔无法散大的小瞳孔白内障手术中应用的有效性和安全性。方法回顾该院2014年3月—2015年12月采用术中置入虹膜扩张器辅助瞳孔开大的瞳孔粘连和瞳孔无法散大的白内障、玻璃体切割手术,其中瞳孔粘连及瞳孔无法散大的小瞳孔白内障手术11例,小瞳孔白内障联合玻璃体切割手术2例。结果术前瞳孔最大径1.5~4.0mm,平均3.5mm,术中置入虹膜扩张器后瞳孔扩张至直径6mm,白内障及玻璃体切割手术得以顺利进行,术毕取出虹膜扩张器,7例术中有少量前房出血,术后第二天前房出血消失,6例术后瞳孔无明显变形,7例术后瞳孔轻度变形。结论虹膜扩张器于瞳孔粘连或瞳孔无法散大的小瞳孔白内障手术中应用可辅助手术的顺利进行,同时避免因暴力扩张瞳孔导致严重并发症,术中、术后并发症主要是早期的短暂性前房出血和轻度的瞳孔变形。

Objective To study the efficacy and safety of IRIS and pupil expander in adhesion and the pupil cannot be applied in small pupil cataract surgery.Methods Retrospective data from March2014 to December 2015 were analyzed in patients with pupil expander-assisted dilatation of the pupil of the IRIS adhesion and pupils trapped a large cataract,vitrectomy.Among them,pupils adhesions and pupil trapped small pupil cataract surgery was in11 cases,small pupil cataract combined with vitrectomy in2 cases.Results Before operation,pupil maximum diameter was 1.5-4.0mm,average 3.5mm,and the reset into IRIS expansion device pupil expanded to diameter 6mm during operation,in which cataract and the vitreous cutting surgery could to do smoothly.After taking out IRIS expansion device,7 cases was in few anterior chamber bleeding,and the bleeding disappeared in the second day postoperation;there were no obviously pupil deformation in6 cases,mild pupil deformation in7 cases.Conclusion The IRIS dilator in pupil adhesions or pupil cannot be applied in small pupil cataract surgery can assist the smooth operation,while avoiding the violent expansion of pupil led to serious complications,intraoperative and postoperative complications of early short anterior chamber bleeding and mild deformation of the pupil.