首页|Ando孔在玻璃体视网膜手术联合硅油填充眼中的应用进展

Ando孔在玻璃体视网膜手术联合硅油填充眼中的应用进展

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硅油作为一种稳定的眼内填充物广泛的应用于各种玻璃体视网膜手术中,但可由于多种原因导致硅油迁移至前房,引起瞳孔阻滞性青光眼、角膜内皮失代偿和角膜病变等并发症。下方周边虹膜切开孔又称Ando孔可以将眼后节积聚的房水引流至前房,房水压迫硅油退回玻璃体腔,从而能够有效应对并发症。近年来Ando孔的应用从无晶状体眼逐渐扩展至有晶状体眼及人工晶状体眼。Ando孔直径≥2 mm。Ando孔切开位置需位于6点时钟位虹膜根部、前房硅油滴下缘或下方房水区。手术后Ando孔可因炎症或血细胞堵塞等原因关闭,此时可采用激光光凝治疗、周边虹膜切除手术、针头穿刺等方法使其再次通畅。目前Ando孔在玻璃体视网膜手术的应用均无统一标准,值得进一步研究。
Progress in the application of the Ando iridectomy in vitreoretinal surgeries with silicone oil tamponade
Silicone oil is a stable intraocular tamponade widely used in various vitreoretinal surgeries.However,it can migrate into the anterior chamber for various reasons,leading to complications such as pupillary block glaucoma,corneal endothelial decompensation,and keratopathy.The inferior peripheral iridectomy(later referred to as the Ando iridectomy)can allow the aqueous humor from the posterior segment to drain into the anterior chamber,and this drainage exerts pressure on the silicone oil,pushing it back into the vitreous cavity,thereby effectively addressing the complications.The application of the Ando iridectomy has expanded from aphakic eyes to phakic eyes and pseudophakic eyes in recent years,each with specific indications.The diameter of the Ando iridectomy should be≥2 mm.The incision for the Ando iridectomy should be made at the 6 o'clock position at the iris root,at the lower edge of the silicone oil droplet in the anterior chamber,or in the inferior aqueous humor zone.Postoperatively,the Ando iridectomy may close due to inflammation or blood cell blockage.In such cases,it can be reopened using laser photocoagulation,surgical peripheral iridectomy,or needle puncture to restore its functionality.Currently,there is no standardized protocol for the application of the Ando iridectomy in vitreoretinal surgeries,and this warrants further research.

Peripheral iridectomySilicone oilVitreoretinal surgeryReview

蒋宇琦、谢海南、黄厚斌

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解放军总医院解放军医学院,北京 100853

解放军总医院海南医院眼科,三亚 572013

解放军总医院眼科医学部,北京 100853

周边虹膜切除手术 硅油 玻璃体视网膜手术 综述

军队后勤科研项目保健专项课题海南省卫生健康行业科研项目军委后勤保障部保健专项科研课题面上项目

23BJZ3722A20035119BJZ39

2024

中华眼底病杂志
中华医学会

中华眼底病杂志

CSTPCD北大核心
影响因子:0.928
ISSN:1005-1015
年,卷(期):2024.40(10)