虹膜根部离断修复术

Microsurgery repair of iridodialysis

目的 :探讨虹膜根部离断修复术的简便方法。方法 :34例、34眼采用角膜缘后 1～ 1.5mm巩膜切口 ,自透明角膜穿刺口注入玻璃酸钠 ,软性分离虹膜后黏连 ,使卷缩的虹膜复位 ,分段切开前房时 ,排出前房积血和渗出物 ,虹膜根部随脱出的玻璃酸钠脱出巩膜内切口部位 ,用 10 - 0铲形针线自切口后唇巩膜面进针全层缝合 ,挂少许虹膜根部组织自前唇巩膜出针 ,结扎于巩膜面 ,虹膜根部牵挂内切口表面 ,与内切口表面组织黏连 ,术中利用玻璃酸钠使虹膜复位 ,排出积血 ,维持前房 ,保护眼内组织。结果 :34例、34眼中术后瞳孔复圆 31例 ,欠圆 3例 ,但瞳孔直径不一 ,伤后距手术时间短者效果好 ,时间长者由于虹膜广泛黏连、萎缩、复位后效果欠佳。术后无 1例发生浅前房 ,继发青光眼 ,角膜内皮损伤等。术后视力有不同程度的提高。术后1月房角镜检查 2 9例 ,2 7例虹膜根部附着于巩膜突出部位 ,2例附着于房角隐窝处 ,无 1例与小梁和角膜黏连。结论 :此法损伤小 ,复位准确 ,操作简便 。

Objective:To investigate the simple method for iridodialysis restoration prognosis. Methods:With scleral incision, total suturation, the iridodialysis was insterted on the surface of medialis of the scleral incision. By injecting viscoelastics into anterior chamber, the iridodialysis was replaced, the iris conglutination and hyphema were dealed with easily. Result: In 34 cases (34 eyes) with iridodialysis, the iris and the pupils were anatomically repaired successfully. It was verified by gonioscopy of postoperation. Conclusion: This method can make the iridodialysis repositon.