iris suture

Iris suture is suitable for the accompanying vitreous detachment from the iris to the anterior chamber, or anterior chamber hemorrhage, simple suture is difficult to operate. It is also suitable for arc-shaped iris incision caused by mistakes in the expansion of the incision in the anterior segment. Treating diseases: iritis Indication 1. The root of the iris caused by trauma or surgery is exposed to the suspensory ligament, and there is a risk of vitreous prolapse. 2. The root of the iris is broken, the pupil is deformed, and the pupil is contracted to open the large shape. 3. The fracture is located in the cleft palate area and produces a monocular double vision. 4. After the iris is adhered, the lens is not completely dislocated, and the iris is separated by suspending the upper root, and the dislocated lens is suspended and suspended. 5. Suture the upper radial iris incision to restore the iris mechanical barrier. Contraindications 1, with systemic diseases, can not tolerate surgery. 2, local infection, not suitable for surgery. Preoperative preparation 1. Those who have large dilated pupils, the sputum sputum medicine shrinks, otherwise it will not shrink. 2. Patients with secondary glaucoma, first use drugs to reduce intraocular pressure to normal. Surgical procedure Mccannel iris root dissection repair (1) The rectus muscle is fixed in the direction of the root of the iris to fix the eyeball. 10mm ball conjunctival incision, with the shovel type on the 10-0 nylon line should be at the junction of the outer and outer 1/3 of the iris, from the iris at 0.5mm behind the limbus, parallel to the iris into the sclera, the tip of the needle extends forward to the free end Behind the root iris, the needle was rotated perpendicularly to the cornea from the margin of 0.5 mm and passed through the peripheral cornea. (2) Wear the second or third suture in the same way. Make a 2mm horizontal scleral puncture at the center of the break. (3) Extend the iris hook and pull the suture from the iris to the cornea to the outside of the incision. (4) The suture is tightened and ligated outside the sclera. (5) The root of the broken iris will be pulled to the anterior chamber angle, and the excess suture will be cut off, and the conjunctiva will not need to be sutured. Incision suture It is suitable for the absence of the vitreous body from the detachment of the anterior chamber of the iris, or the anterior chamber hemorrhage. It is also suitable for arc-shaped iris incision caused by mistakes in the expansion of the incision in the anterior segment. A horizontal incision is made at the edge of the cornea at the root of the iris, and the length is slightly smaller than the fracture zone. The local vitreous resection is performed through the disconnection area, and the front hemorrhage is washed. After the iris root is clearly seen, the iris is clamped to the root of the iris and pulled out a little outside the incision. The 10-0 nylon thread passes through the root and is about 0.5 mm, and then The incision of the posterior lip of the posterior lip under the scleral flap, knotted to leave the knot in the incision. According to the size of the disconnection, it is determined whether the suture needs to be added, and the interval is usually 2 to 3 mm, and the main incision is intermittently sutured to a watertight state. In order to prevent the iris from coming out of the leak. Radial iris incision Applicable to intraoperative radial incision, narrow segmental resection or traumatic radial iris tear. (1) machenson suture method: 0.5mm into the 10-0 nylon thread in the peripheral iris margin near the incision and through the 0.5mm inside the contralateral margin, pull the suture out of the incision, gently knot, keep The original line is used as a traction line. Slightly pull out the 2~3mm iris from the incision, and make a similar broken edge suture near the edge of the pupil. The innermost needle is located at the edge of the pupil, and the knot is located on the surface of the iris. The iris is restored and the corneoscleral incision is sutured. (2) Corneal suture: suitable for irises with small amplitude and certain elasticity. In the vertical direction of the meridian where the iris is broken, a 1 mm full-thickness corneal puncture is made from 6 to 8 mm, and a small amount of viscoelastic is injected into the anterior chamber. The curved needle 10-0 nylon thread with a radius of 8 to 12 mm is used from the right side. The incision was penetrated and passed through both sides of the iris at a distance of about 0.5 mm and then through the left incision. The needle is returned from the left incision through the anterior surface of the iris, piercing from the right puncture, tightening the nylon thread, pulling the iris suture edge to the outside of the incision, cutting off the excess thread, using the iris restorer or viscoelastic The agent pushes the iris located in the incision into the anterior chamber, and determines whether to perform the second and third stitches according to the width of the broken edge. In the cleft palate area, 2 to 3 needles can be sutured, and the upper suture is 1 to 2 needles.

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