目的:探讨下方角巩膜缘牵引缝线在眼科手术中的应用价值和操作技巧。方法:应用下方角巩膜缘牵引缝线方法固定眼球,暴露手术野协助完成眼科手术163例181眼,包括小切口白内障囊外摘出术联合人工晶状体植入术86例98眼,青光眼小梁切除术48例54眼,青光眼白内障联合手术10例10眼,结膜瓣遮盖手术8例8眼,玻璃体腔注气术3例3眼,外伤性睫状体脱离缝合复位手术2例2眼,经睫状体平坦部三通道玻璃体切除手术6例6眼。用直尺测量12∶00位角巩膜缘至上睑缘的距离(mm)。结果:应用下方角巩膜缘牵引缝线协助完成眼科手术163例181眼,操作效果满意者160例178眼,占98.3%。不满意者3例3眼,占1.7%,暴露不满意者为青光眼伴小睑裂患者行外眦开大术后达到满意效果,无1例发生并发症。测量12∶00位角巩膜缘至上睑缘的距离为9.5±3.5mm。结论:下方角巩膜缘牵引缝线在固定眼球和暴露手术野方面能够顺利协助完成眼科手术,具有操作简单,安全性高,实用性强的特点,效果满意,可以代替上直肌牵引缝线,值得临床眼科医生在手术操作中应用。

AIM:To evaluate the value and surgical technique of traction suture of inferior corneoscleral limbus in ophthalmology surgery·METHODS:Traction suture of inferior corneoscleral limbus was applied in 163 patients(181 eyes) of ophthalmic surgery,including small incision extracapsular cataract extraction with intraocular lens implantation in 86 patients(98 eyes),glaucoma trabeculectomy in 48 patients(54 eyes),cataract surgery combined with glaucoma surgery in 10 patients(10 eyes),conjunctival flap covering surgery in 8 patients(8 eyes),intravitreal gas injection in 3 patients(3 eyes),suturing reattachment of traumatic ciliary body detachment in 2 patients(2 eyes),pars plana vitrectomy in 6 patients(6 eyes).The distance from superior limbus to superior palpebral margin was measured on 12∶00 with ruler·RESULTS: Totally 160 patients 178 eyes,98.3% in ophthalmic surgery can be smoothly proceeded with traction suture of inferior corneoscleral limbus,3 cases(3 eyes,1.7%) in glaucoma patients with small palpebral fissue were also operated after canthotomy.It is 9.5±3.5mm from superior limbus to palpebral margin.No complications from traction suture occurred·CONCLUSION:Traction suture of inferior corneoscleral limbus is safe,effective and simple,it can take the place of superior rectus traction suture and worthes to be applied for doctors in ophthalmic surgery.

R779.6