摘要
目的 探讨预防人工晶状体缝线固定术后缝线侵蚀的方法。方法 回顾行人工晶状体缝线固定术的 95例患者 98眼 ,术中采用巩膜隧道自动埋藏线结的缝合方法 ,其中 4点固定 8眼 ,双襻固定 69例 72眼 ,单襻固定 18例18眼 ,固定线结共 194个。缝线方法为 :在需埋藏线结处做深约 0 .5m m ,潜行约 1.5m m的巩膜隧道。人工晶状体植入后房后 ,将自巩膜隧道穿出的、固定襻的双股聚丙烯线拉紧 ,剪断其中一股 ,另一股随缝针先自巩膜隧道内进针 ,向外穿出巩膜 ,再自另一唇巩膜外进针 ,至切口内出针 ,然后与剪断的一股打结 ,这样线结位于巩膜隧道内 ,用镊子或冲洗针头将线结推至与隧道平行的方向。术后观察线结外露出巩膜和结膜的情况。结果 随访 0 .5～ 3 2个月 ,平均 16.5个月。 190个线结中 ,仅 1个线结 (0 .52 % )术后向外侵蚀巩膜而外露于结膜下 ,外露的原因为巩膜隧道的前层太薄 ,同时线结过短不易倒向与巩膜平行的方向。未发现因缝线内蚀巩膜而使人工晶状体偏位的现象。结论 巩膜隧道自动埋藏线结的缝合方法操作简单 ,能有效地埋藏人工晶状体缝线固定术中的聚丙烯线结 ,术后缝线侵蚀的发生率极低。
Objective To search for a suturing technique for the prevention of suture erosion after transscleral fixation of posterior chamber intraocular lenses.Methods We modified the suturing method during transscleral fixation of intraocular lens and used it in 95 cases ( 98 eyes ), including 4-point fixation in 8 cases ( 8 eyes ), 2-point fixation in 69 cases ( 72 eyes ) and single-haptic fixation in 18 cases ( 18 eyes ). The total number of Prolene suture knot was 194. The modified technique: a scleral tunnel was made for burying the suture knot. The double-thread PC-9 Prolene suture passing through the tunnel was used to fix the intraocular lens in the posterior chamber. After this, one of the thread was cut and the needle with the other thread passed from inside the tunnel to outside the sclera, then inserted from outside the sclera of the other lip of the tunnel incision to inside the tunnel. The two threads were then tied and the knot was buried in the tunnel spontaneously. Results Mean follow-up was 16.5 months ( 0.5~32 months ). Among the 194 suture knots, only one knot ( 0.52% ) eroded through the sclera and exposed under the conjunctiva.Conclusion The modified technique can easily bury the Prolene suture knots in the sclera tunnel and effectively prevent suture erosion.
出处
《眼科新进展》
CAS
2002年第1期44-45,共2页
Recent Advances in Ophthalmology
关键词
缝线侵蚀
经巩膜固定
晶状体
suture erosion
transscleral fixation
intraocular lens
