incarcerated iris

It is rarely used because it is suspected that sympathetic ophthalmia may occur after surgery. Treating diseases: glaucoma Indication Drug and laser treatments do not prevent glaucoma of various types of progressive optic nerve damage and visual field defects. Due to improvements in surgical techniques and the use of antimetabolites, intraocular pressure levels after trabeculectomy can be similar to those of full-thickness scleral penetrating filtration, so trabeculectomy is now available for almost all needs. Glaucoma for extraocular filtration. However, it is rarely used because of suspected sympathetic ophthalmia after surgery. Contraindications 1, with systemic diseases, can not tolerate surgery. 2, local infection, not suitable for surgery. Preoperative preparation Patients should be informed enough about their condition and prognosis. Adjust the preoperative medication. Proine or 1% adrenaline, anti-cholinesterase inhibitors such as iodine phosphate, superior gaze, etc. should be discontinued for two weeks in order to reduce vascular congestion and intraoperative bleeding. The carbonic anhydrase inhibitor and the -adrenergic blocker were stopped for 2 to 3 days, so that the formation of aqueous humor was normal after the operation, which was conducive to the formation of filtration bleb. Antibiotic eye drops such as 0.3% tobramycin were added 3 days before surgery. Gentamicin eye drops may stimulate the bulbar conjunctiva, causing conjunctival hyperemia and avoiding it as much as possible. 1% prednisolone can be started on the day before surgery, 4 times a day. If the patient has not used pilocarpine, use it 1 or 2 times a day before surgery. If the preoperative intraocular pressure is significantly elevated (above 40mmHg), 20% mannitol should be administered intravenously to reduce intraoperative complications. If the patient takes aspirin, it should be discontinued for 5 days. If there are new blood vessels in the iris or anterior chamber angle, panretinal photocoagulation should be performed first to increase the success rate of filtration. Surgical procedure 1. The method of corneal scleral keratotomy, sutured rectus muscle line and bulbar conjunctival flap based on the limbus is the same as scleral enema. 2. Flip the conjunctival flap, and cut the sclera vertically with the blade at the posterior edge of the limbus and enter the anterior chamber. The length of the incision is about 4 mm. 3. After the abutment is closed, the incision is inserted into the anterior chamber through the incision, and the iris near the edge of the pupil is clamped. The surgeon's hand or assistant should lift the conjunctival flap so that the surgeon can see the position of the iris. 4. Pull the iris out of the scleral incision, and the surgeon or assistant and the assistant hold the iris to clamp the sides of the extracted iris. 5. Use the iris scissors to make a radial incision in the center, from the edge of the pupil to the root of the iris. 6. Invert the two sheared iris columns so that the pigment epithelial layer is upwardly placed on both sides of the scleral incision to expose the central portion of the gap. 7. The method of restoring the bulbar conjunctival flap, suturing the bulbar conjunctiva and the bulbar fascia wound is the same as trabeculectomy. complication Sympathetic ophthalmia.

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