Proper wound construction to prevent short-term ocular hypotony after clear corneal incision cataract surgery
Proper wound construction to prevent short-term ocular hypotony after clear corneal incision cataract surgery
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DOI：
10.1016/j.jcrs.2006.11.006
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发表时间：
2007-03-01
影响因子：
2.8
通讯作者：
Belani, Shaleen
中科院分区：
文献类型：
--
作者：
Masket, Samuel;Belani, Shaleen
目的：评估具有方形或接近方形表面结构的 2.2 毫米和 3.0 毫米透明角膜白内障切口的稳定性。地点：美国加利福尼亚州世纪城的私人门诊门诊手术中心。方法：对 2006 年 1 月至 9 月期间进行透明角膜白内障摘除术的 60 名患者进行回顾性图表审查。 50 名患者采用 2.2 毫米方形切口进行透明角膜白内障摘除术，10 名患者采用近方形 3.0 毫米切口进行角膜白内障摘除术。对于 2.2 毫米切口子集，白内障手术和人工晶状体植入是通过使用 Alcon Infiniti 装置和 Ultrasleeve 输注通过未扩大的 2.2 毫米透明角膜白内障切口完成的。对于 3.0 mm 子集，使用 Allergan Sovereign 装置。每次手术结束时，术中使用 Schiotz 或 Barraquer 眼压计测量眼压 (IOP)，并将其设置在 15 mm Hg 至 20 mm Hg 之间。所有病例均通过术中赛德尔测试确认伤口密封。每次手术结束后 2 小时至 6 小时内，通过 Tono-Pen (Medtronic) 或 Goldmann 压平眼压计测量眼压。 结果：在 2.2 mm 方形切口和 16.6 +/- 5.2 mm 组中，术后平均 IOP 为 19.2 mm Hg +/- 4.9 (SD)（中位 18 mm Hg；范围 11 至 35 mm Hg）。具有 3.0 毫米近方形透明角膜切口的组中的汞柱（中位值 16.0 毫米汞柱；范围 10 至 25 毫米汞柱）。没有患者的眼压低于 10 mm Hg，并且通过 Seidel 测试，两组中均没有低眼压或伤口渗漏的证据。结论：经过仔细检查密封性的方形或近方形表面结构的透明角膜伤口术后稳定，没有低眼压和伤口渗漏即可证明。在存在密封的透明角膜伤口的情况下，眼压相对于手术结束时设定的水平保持相当稳定。
PURPOSE: To evaluate the stability of 2.2 mm and 3.0 mm clear corneal cataract incisions with square or nearly square surface architecture.SETTING: Private practice ambulatory surgical center, Century City, California, USA.METHODS: A retrospective chart review of 60 patients who had clear corneal cataract extraction between January and September 2006 was conducted. Fifty patients had clear corneal cataract extraction with a square 2.2 mm incision and 10 patients with a nearly square 3.0 mm incision. For the 2.2 mm incision subset, cataract surgery and intraocular lens implantation were accomplished through an unenlarged 2.2 mm clear corneal cataract incision using the Alcon Infiniti unit and an Ultrasleeve for infusion. For the 3.0 mm subset, the Allergan Sovereign unit was used. Intraocular pressure (IOP) was measured intraoperatively at the conclusion of each procedure with a Schiotz or Barraquer tonometer and set between 15 mm Hg and 20 mm Hg. Wound sealing was confirmed by intraoperative Seidel testing in all cases. Intraocular pressure was measured by a Tono-Pen (Medtronic) or Goldmann applanation tonometry between 2 hours and 6 hours after the conclusion of each procedure.RESULTS: The mean postoperative IOP was 19.2 mm Hg +/- 4.9 (SD) (median 18 mm Hg; range 11 to 35 mm Hg) in the group with a 2.2 mm square incision and 16.6 +/- 5.2 mm Hg (median 16.0 mm Hg; range 10 to 25 mm Hg) in the group with a 3.0 mm nearly square clear corneal incision. No patient had an IOP less than 10 mm Hg, and there was no evidence of hypotony or wound leakage by Seidel testing in either group.CONCLUSIONS: Clear corneal wounds of square or nearly square surface architecture that are meticulously checked for sealing were stable postoperatively as demonstrated by the absence of hypotony and wound leakage. In the presence of a sealed clear corneal wound, IOP remained reasonably stable relative to the level set at the conclusion of the procedure.