Vitrectomy with endoscopy for management of retained lens fragments and/or posteriorly dislocated intraocular lens
Vitrectomy with endoscopy for management of retained lens fragments and/or posteriorly dislocated intraocular lens
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内窥镜玻璃体切除术用于处理保留的晶状体碎片和/或后脱位的人工晶状体
DOI：
10.1007/s004170050051
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发表时间：
1998
期刊：
影响因子：
--
通讯作者：
J. Nguyen
中科院分区：
文献类型：
--
作者：
C. Boscher;D. Lebuisson;J. Lean;J. Nguyen
摘要 • 目的：评估玻璃体切除术联合内窥镜治疗晶状体碎片和/或人工晶状体后脱位的优势。 • 方法：对采用该技术治疗的连续 30 只患有这些并发症的眼睛进行回顾性研究。使用包含视频通道、光纤光源和二极管激光器的内窥镜探头进行可视化。 18 只眼睛（60%）通过角膜伤口取出晶状体材料或人工晶状体。在内窥镜控制下，使用全氟化碳液体 (PFCL) 吸出、抓握或举起它们。 9 只眼睛 (30%) 进行了晶状体扁平部超声乳化术。 11只眼（36.6%）使用了PFCL。 16 只眼睛 (53.3%) 在睫状沟中缝合了 IOL。 • 结果：最终视力≥20/40的有19只眼（63.3%），≥20/30的有15只眼（50%）。在该系列的早期，两只眼睛发生了术中破裂（其中一个病例是由于使用内窥镜，另一例是由于晶状体平坦部乳化术）。最终视力不佳与增殖性玻璃体视网膜病变有关，两例病例均伴有术中医源性视网膜裂孔、老年性黄斑变性、近视和弱视、黄斑囊样水肿、角膜水肿和高度散光。 • 结论：我们发现，一旦掌握了该技术的特殊困难（缺乏立体镜、内窥镜操作、视频监视器控制），内窥镜检查就有助于处理白内障手术的这些并发症。内窥镜促进并缩短了嵌入玻璃体基底的晶状体碎片的定位，以进行抽吸、抓握和晶状体乳化，能够检测小的前部视网膜裂孔，允许切除前部玻璃体、晶状体囊和睫状沟之间的粘连，并促进PFCL操作，无论眼前节的状态如何（角膜水肿、肌病、粘连、存在IOL）。
Abstract • Purpose: To evaluate the advantages of vitrectomy combined with endoscopy for the management of retained lens fragments and/or posteriorly dislocated intraocular lens (IOL). • Methods: A consecutive series of 30 eyes with these complications treated by this technique was reviewed retrospectively. An endoscopic probe which incorporates a video channel, a fibreoptic light source, and a diode laser was used for visualization. Lens material or the IOL was extracted through the corneal wound in 18 eyes (60%). They were either aspired or grasped or lifted using perfluorocarbon liquids (PFCL), under endoscopic control. In 9 eyes (30%) pars plana phakoemulsification was performed. PFCL was used in 11 eyes (36.6%). In 16 eyes (53.3%) an IOL was sutured in the ciliary sulcus. • Results: Final visual acuity was ≥20/40 in 19 eyes (63.3%), ≥20/30 in 15 eyes (50%). Intraoperative breaks occurred early in the series in two eyes (in one case from use of the endoprobe, in the other from pars plana phakoemulsification). Poor final acuity was related to proliferative vitreoretinopathy, which developed in both cases with an intraoperative iatrogenic retinal break, senile macular degeneration, myopia and amblyopia, cystoid macular oedema, corneal oedema and high astigmatism. • Conclusion: We found that endoscopy facilitated the management of these complications of caratact surgery once the peculiar difficulties of the technique (absence of stereoscopy, manipulation of the endoprobe, video monitor control) were mastered. Endoscopy facilitated and shortened localization of lens fragments embedded into the vitreous base for aspiration, grasping and phakoemulsification, enabled detection of small anterior retinal breaks, permitted resection of adhesions between anterior hyaloid, lens capsule and ciliary sulcus and facilitated PFCL manipulations, whatever the status of the anterior segment (corneal edema, myosis, synechiae, presence of IOL).
全氟全氢菲在治疗晶状体后脱位和人工晶状体中的应用。
DOI：
--
发表时间：
1993
期刊：
Ophthalmic surgery
影响因子：
--
作者：
Greve,MD;Peyman,GA;Mehta,NJ;Millsap,CM
通讯作者：
Millsap,CM