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目的 :观察双直针直接缝合法治疗虹膜根部离断的疗效。方法 :14例虹膜根部离断患者 ,合并外伤性白内障 10例 ,晶状体脱位 6例 ,继发性青光眼 4例 ,睫状体脱离 1例。 14例行双直针直接缝合法修复虹膜根部离断 ,同时联合晶状体玻璃体切割 5例 ,白内障囊外摘除及人工晶状体植入 2例 ,睫状体脱离复位 1例 ,小梁切除术 1例。通过角膜缘穿刺口 ,向前房注入粘弹剂 ,离断的虹膜被推回原位。 10 -0聚丙烯双直针分别自同一角膜缘穿刺口或玻璃体切割三切口 ,潜行于虹膜与晶状体之间或虹膜与角膜之间 ,在距虹膜根部 0 5～ 1mm穿针 ,自角膜缘后 1mm房角处穿出角膜缘并打结 ,可将线结埋藏于三角形巩膜瓣下或转入眼内或于球结膜下。打结松紧要适度 ,缝合的针数可根据虹膜离断的范围确定 ,以虹膜复位、瞳孔复圆为度。结果 :14例离断的虹膜都得到较为满意的修复 ,基本恢复了虹膜的位置和瞳孔形态 ,使视力及外观明显改善。结论 :双直针直接缝合复位法修复虹膜根部离断是一种微创、安全、简便、有效的手术方式 ,值得临床上推广应用
Objective: To observe the curative effect of double-needle direct suture treatment on iris root rupture. Methods: Totally 14 patients with iris root fracture, 10 cases with traumatic cataract, 6 cases with lens dislocation, 4 cases with secondary glaucoma and 1 case with ciliary body detachment. 14 cases of double straight needle suture repair Iris rupture, combined with vitrectomy in 5 cases, extracapsular cataract extraction and intraocular lens implantation in 2 cases, ciliary body detachment in 1 case, 1 case of trabeculectomy. Through the limbus puncture, injection of viscoelastic into the anterior chamber, the broken iris is pushed back to its original position. 10 -0 polypropylene double straight needle from the same limbus puncture or vitrectomy incision, sneak in the iris and lens between the iris and the cornea, from the root of the iris 05 ~ 1mm needle, from the limbus after the edge of 1mm Perforating at the corner of the corneal limbus and knotted, the knot can be buried under the triangular scleral flap or into the eye or under the conjunctiva. Tight knot loose moderate, the number of stitches can be determined according to the scope of the iris off to iris reset, pupil complex round degree. Results: All the 14 cases of iris were repaired satisfactorily, which basically restored the position of iris and pupil morphology, which improved visual acuity and appearance. Conclusion: It is a safe, simple and effective surgical method to repair iris root rupture with double-needle direct suturing and reduction, which is worth to be popularized clinically