目的:探讨儿童眼前段穿通伤急诊手术中的操作技巧以减少术后并发症。方法:术中应用黏弹剂保护虹膜并行虹膜还纳,通过角膜缘透明侧切口显微虹膜恢复器充分分离伤口与虹膜及近前房角处的粘连,用621号晶状体双腔针注吸黏弹剂及虹膜面血性物及渗出膜,及时形成前房,维持了晶状体虹膜膈的正常位置。结果:儿童36例眼前段穿通伤术后仅1例发生虹膜前粘连,瞳孔轻度变形,治疗成功率97%。结论:在儿童眼前段穿通伤急诊手术中应用黏弹剂还纳虹膜,通过角膜缘透明侧切口分离粘连渗出膜并联合前房注吸,能降低术后并发症,提高手术成功率。

AIM:To explore the operating skills of emergency surgeries for children’s penetrating wound of anterior segment so as to reduce postoperative complications.METHODS:Use viscoelastic to protect iris and put the iris back into the eyeball.Separate the adhesion at the anterior chamber between iris and cornea and the adhesion between iris and the wound by iris restitutor through the side incision at the limbus of the cornea.Irrigate and aspirate the viscoelastic and the bloody exudation on the surface of the iris by 6 12 double-lumen lens needle to form and maintain the anterior chamber and the normal position of the lens iris diaphragm.RESULTS:In 36 patients,only 1 child had synechia and mild iris deformation postoperatively.The success rate was 97%.CONCLUSION:Using viscoelastic to protect the iris,separating the adhesion at the anterior chamber between the iris and the cornea and the adhesion between iris and the wound,irrigating and aspirating the viscoelastic and the bloody exudation on the surface of the iris can reduce complications and improve success rate in the emergency surgeries for children’s anterior segment injury.

R779.6