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目的探讨虹膜扩张器在瞳孔粘连和瞳孔无法散大的小瞳孔白内障手术中应用的有效性和安全性。方法回顾该院2014年3月—2015年12月采用术中置入虹膜扩张器辅助瞳孔开大的瞳孔粘连和瞳孔无法散大的白内障、玻璃体切割手术,其中瞳孔粘连及瞳孔无法散大的小瞳孔白内障手术11例,小瞳孔白内障联合玻璃体切割手术2例。结果术前瞳孔最大径1.5~4.0mm,平均3.5mm,术中置入虹膜扩张器后瞳孔扩张至直径6mm,白内障及玻璃体切割手术得以顺利进行,术毕取出虹膜扩张器,7例术中有少量前房出血,术后第二天前房出血消失,6例术后瞳孔无明显变形,7例术后瞳孔轻度变形。结论虹膜扩张器于瞳孔粘连或瞳孔无法散大的小瞳孔白内障手术中应用可辅助手术的顺利进行,同时避免因暴力扩张瞳孔导致严重并发症,术中、术后并发症主要是早期的短暂性前房出血和轻度的瞳孔变形。
Objective To investigate the effectiveness and safety of iris dilator in the pupil cataract surgery and small pupil cataract surgery. Methods The hospital from March 2014 to December 2015 using intraoperative iris dilator assisted pupil dilated pupil adhesion and pupil can not be scattered cataract, vitrectomy surgery, in which pupil adhesion and pupil can not be scattered small Pupil cataract surgery in 11 cases, small pupil cataract combined vitrectomy in 2 cases. Results The maximum diameter of pupil before operation was 1.5-4.0mm, with an average of 3.5mm. The pupil was dilated to 6mm in diameter after surgery. Cataract and vitrectomy were performed successfully. The iris dilator was removed at 7th day A small amount of the anterior chamber hemorrhage, the disappearance of the anterior chamber hemorrhage the day after the operation, 6 cases of postoperative pupil no obvious deformation, 7 cases of postoperative pupil mild deformation. Conclusion Iris dilator in the pupil adhesions or pupil can not be scattered in small pupil cataract surgery can be applied to facilitate the smooth progress of the surgery, while avoiding the violence caused by the expansion of the pupil of serious complications, intraoperative and postoperative complications are mainly early transient Anterior chamber bleeding and mild pupil deformity.