Iridectomy

Iris adhesion is generally a complication after intraocular inflammation. If the adhesion is tight, the pupil may not be enlarged and reduced. Complete adhesion may cause glaucoma, and the iris adhesion may be corrected. Treating diseases: iritis Indication 1. Iris bulging, widely associated with the corneal endothelium. 2. The iris and the cornea have a bundle, a band-like anterior adhesion, a new tube growth, and a recurrent active iritis. 3. The iris adheres to the cornea and has a fiber bundle and vitreous adhesion, and there is a risk of traction retinal detachment. 4. Iris adhesion affects the shape of the pupil, displacement of the pupil, affecting the intraocular surgery operator. 5. Pre-iris adhesion causes corneal deformation, wrinkling, and invagination. Contraindications 1, with systemic diseases, can not tolerate surgery. 2, local infection, not suitable for surgery. Preoperative preparation 1. Drip large muscle stimulants to enhance the tension of the iris, while cataract surgery can apply ciliary muscle paralysis. 2. Argon laser photocoagulation closes the iris neovascularization. 3. Preoperative intravenous drip of mannitol reduces intraocular pressure. 4. Anti-inflammatory drugs. Surgical procedure 1. Open the eyelid to open the eyelid and fix the upper rectus muscle. 2. Make a conjunctival flap based on the iliac crest, and the surface of the sclera is burned to stop bleeding. 3. Incision. In addition to the main incision centered at 12 o'clock for cataract glaucoma surgery, in order to facilitate the separation of adhesions, a 1 mm horizontal puncture can be made at 10 o'clock 2 o'clock or 0.5 mm inside the iliac margin. 4. The front room is shaped. Inject the viscoelastic agent to fill the anterior chamber and push the iris to separate from the cornea. Separation and release of pre-adhesion (1) Injecting a viscoelastic agent around the pre-iris adhesion. (2) Micro-iris clipping The inner surface of the cornea is cut to form a bundle of anterior adhesions. (3) If it is a linear iris adhesion, and it is difficult to separate, a 2mm horizontal incision can be made at the edge of the adhesion at the end of the adhesion, and a small amount of viscoelastic is injected into both sides of the iris adhesion. The two edges of the scissors extend from both sides of the end of the adhesive line. The anterior chamber extends all the way to the end of the adhesion line or directly to the opposite side angle, closes the scissors, and cuts the adhesion iris once. (4) When the adhesion is released, the cornea will restore its original convexity, and the cut iris and fiber cord will move back, and the anterior chamber will be deepened. The needle will no longer have any resistance when it is swung from under the original adhesion point, and the anterior chamber air bubble will be round. Separation and release of post-adhesion (1) Inject the viscoelastic agent into the back through the pupil and swing the needle to separate the adhesion. (2) Or make a small peripheral iris resection or incision under the main incision, the flat needle extends into the back of the iris to inject the viscoelastic agent, the iris that has no adhesion or adhesion has been loosened, and the needle makes a fan-shaped swing under the iris. Isolation of pupillary iris adhesion. (3) It is difficult to separate the adhesion of the fibrous iris. If the central visual axis is not affected, the iris-fiber membrane can be removed. complication 1. Hemorrhage, mostly fibrous membrane blood vessels or iris neovascularization. Rest in a sitting position, oral hemostasis. When the amount is large, the anterior chamber can be washed. 2. Fibrin exudation can form new adhesions, need to dilate, early subconjunctival and systemic application of corticosteroids, located in the pupil area can seriously affect vision, if the cornea is transparent, feasible nd: yag laser to spread the film to reveal pupils . 3. Corneal edema, after the separation of pre-iris adhesion, the number of endothelial cells on the inner surface of the cornea is seriously insufficient, the effect of endothelial cell pump is weakened, corneal epithelium or matrix edema, and will last for several days to several weeks. 4. Lens injury, such as rupture of the anterior capsule, cortical opacity, cortical opacity, cataract surgery can be performed when the visual acuity is seriously affected. 5. The vitreous is prolapsed, bulging from the ligament of the suspensory ligament and having an iris defect, which may be in contact with the corneal endothelium, or the pupillary block, and the anterior vitreous is removed.