目的:评价改良折叠式人工晶状体(IOL)悬吊治疗外伤性晶状体脱位的手术技术。方法:前瞻性随机对照研究。共15例患者接受了改良折叠式IOL悬吊手术。其中,9例患者选择了Akreos AO IOL,使用聚丙烯缝线穿过IOL的环状襻,经巩膜引导穿刺后,缝...目的:评价改良折叠式人工晶状体(IOL)悬吊治疗外伤性晶状体脱位的手术技术。方法:前瞻性随机对照研究。共15例患者接受了改良折叠式IOL悬吊手术。其中,9例患者选择了Akreos AO IOL,使用聚丙烯缝线穿过IOL的环状襻,经巩膜引导穿刺后,缝合线末端热膨胀固定在巩膜。6例患者选择了Tecnis ZA9003 IOL,未使用缝合线,巩膜穿刺引导IOL襻穿出巩膜后,直接将IOL襻末端热膨胀固定在巩膜内。观察所有患者的最佳矫正视力(BCVA,LogMAR)及术后并发症。结果:研究共纳入15例患者,其中男7例,女8例,平均年龄64.00±9.85岁,平均病程5.80±3.17wk。人口统计学和基线临床特征之间没有显著差异。接受改良折叠式IOL悬吊手术后,所有患者视力均有明显改善。术后3mo,患者的BCVA(LogMAR)从1.28±0.56改善至0.52±0.30。其中,选择Akreos AO IOL患者的BCVA(LogMAR)从1.39±0.62改善至0.59±0.25,选择Tecnis ZA9003 IOL患者的BCVA(LogMAR)从1.12±0.45改善至0.42±0.35。此外,在我们的研究中没有观察到严重的术后并发症。仅1例患者IOL脱位,IOL光学面轻度倾斜。结论:改良折叠式IOL悬吊手术具有良好的视觉效果和预后,无严重并发症,是IOL悬吊手术的有效选择。展开更多
AIM: To present with a clinical case series of a mixed 23-gauge infusion and 20-gauge pars plena technique for 5,700-centipoise silicone oil removal (SOR), and to discuss its efficacy and safety. METHODS: This is a re...AIM: To present with a clinical case series of a mixed 23-gauge infusion and 20-gauge pars plena technique for 5,700-centipoise silicone oil removal (SOR), and to discuss its efficacy and safety. METHODS: This is a retrospective, non-randomized controlled study. We performed SOR with 23-gauge infusion and 20-gauge active suction technique on 29 patients 29 eyes from April to October, 2011 (mixed group). During the surgeries, a 23-gauge sclerotomy was made for infusion and a 20-gauge sclerotomy was used for active silicone oil suction. Anterior segment optical coherence tomography (OCT) was applied for 23-gauge sclerotomy analysis 1 day post-operation. Traditional 20-gauge SOR was performed on another consecutive 29 patients 29 eyes, the control group (20G group). RESULTS: There were 2 eyes (6.9%) in mixed group and 5 eyes (17.2%) in 20G group which had recurrent retinal detachment after surgery. Hopytony (IOP <= 6mmHg) occurred in 8 eyes (27.6%) of mixed group and in 10 eyes (34.5%) of 20G group post-operation, but all of them recovered to the normal level finally. There were no statistical significant differences. Final visual acuity was significantly increased after surgery in both groups. Anterior segment OCT images were acquired from 13 eyes of mixed group, and all of them had a proper wound apposition. But local ciliary detachment was found in 9 eyes (69%). It was hard to define the OCT image of the sclerotomies and ciliary body because of the serious conjunctival hemorrhages and chemosis in 20G group. CONCLUSION: This mixed technique is a convenient and effective way to remove high viscosity silicone oil. Compared with traditional 20-gauge SOR, it does not increase the risk of post-operative complications and has less conjunctival reactions.. Transient postoperative hypotony is common for this procedure and subclinical ciliochoroidal detachment is a probable cause.展开更多
文摘目的:评价改良折叠式人工晶状体(IOL)悬吊治疗外伤性晶状体脱位的手术技术。方法:前瞻性随机对照研究。共15例患者接受了改良折叠式IOL悬吊手术。其中,9例患者选择了Akreos AO IOL,使用聚丙烯缝线穿过IOL的环状襻,经巩膜引导穿刺后,缝合线末端热膨胀固定在巩膜。6例患者选择了Tecnis ZA9003 IOL,未使用缝合线,巩膜穿刺引导IOL襻穿出巩膜后,直接将IOL襻末端热膨胀固定在巩膜内。观察所有患者的最佳矫正视力(BCVA,LogMAR)及术后并发症。结果:研究共纳入15例患者,其中男7例,女8例,平均年龄64.00±9.85岁,平均病程5.80±3.17wk。人口统计学和基线临床特征之间没有显著差异。接受改良折叠式IOL悬吊手术后,所有患者视力均有明显改善。术后3mo,患者的BCVA(LogMAR)从1.28±0.56改善至0.52±0.30。其中,选择Akreos AO IOL患者的BCVA(LogMAR)从1.39±0.62改善至0.59±0.25,选择Tecnis ZA9003 IOL患者的BCVA(LogMAR)从1.12±0.45改善至0.42±0.35。此外,在我们的研究中没有观察到严重的术后并发症。仅1例患者IOL脱位,IOL光学面轻度倾斜。结论:改良折叠式IOL悬吊手术具有良好的视觉效果和预后,无严重并发症,是IOL悬吊手术的有效选择。
文摘AIM: To present with a clinical case series of a mixed 23-gauge infusion and 20-gauge pars plena technique for 5,700-centipoise silicone oil removal (SOR), and to discuss its efficacy and safety. METHODS: This is a retrospective, non-randomized controlled study. We performed SOR with 23-gauge infusion and 20-gauge active suction technique on 29 patients 29 eyes from April to October, 2011 (mixed group). During the surgeries, a 23-gauge sclerotomy was made for infusion and a 20-gauge sclerotomy was used for active silicone oil suction. Anterior segment optical coherence tomography (OCT) was applied for 23-gauge sclerotomy analysis 1 day post-operation. Traditional 20-gauge SOR was performed on another consecutive 29 patients 29 eyes, the control group (20G group). RESULTS: There were 2 eyes (6.9%) in mixed group and 5 eyes (17.2%) in 20G group which had recurrent retinal detachment after surgery. Hopytony (IOP <= 6mmHg) occurred in 8 eyes (27.6%) of mixed group and in 10 eyes (34.5%) of 20G group post-operation, but all of them recovered to the normal level finally. There were no statistical significant differences. Final visual acuity was significantly increased after surgery in both groups. Anterior segment OCT images were acquired from 13 eyes of mixed group, and all of them had a proper wound apposition. But local ciliary detachment was found in 9 eyes (69%). It was hard to define the OCT image of the sclerotomies and ciliary body because of the serious conjunctival hemorrhages and chemosis in 20G group. CONCLUSION: This mixed technique is a convenient and effective way to remove high viscosity silicone oil. Compared with traditional 20-gauge SOR, it does not increase the risk of post-operative complications and has less conjunctival reactions.. Transient postoperative hypotony is common for this procedure and subclinical ciliochoroidal detachment is a probable cause.
