本视频为2025年5月于山西省眼科医院所开展的玻璃体视网膜相关院基培训的手术范例之五。
在本视频中,Stewart医生与学员为一名左眼眼内异物、眼铁质沉着伴复杂性白内障的老年男性患者,施行了玻璃体切除术联合白内障超声乳化及眼内异物取出术。
手术地点:山西省眼科医院,太原,山西省,中国
手术医生:Jay M. Stewart医生,加州大学洛杉矶分校 (UCSF),美国
Transcript
0:50 Here we have a small pupil, but we perform the capsulorhexis in a controlled manner so that it remains as an intact circle.
患者瞳孔较小,我们以可控方式完成囊膜环形撕开术,确保其保持完整的圆形。
2:00 We decided to place iris hooks to facilitate the remainder of the surgery.
我们决定放置虹膜拉钩,以便于后续手术操作。
2:35 We did not have confidence in the integrity of the peripheral capsule so we decided to remove the central capsule and cortical material from a posterior approach.
鉴于对周边囊膜完整性缺乏信心,我们决定从后路移除中央囊膜及皮质。
3:49 We perform peripheral indentation in order to ensure complete vitrectomy.
实施周边顶压,以确保玻璃体切除的彻底性。
4:40 We enlarge the sclerotomy in order to permit removal of the intraocular foreign body.
扩大巩膜切口,以便顺利取出眼内异物。
4:54 We locate the metallic foreign body in the peripheral vitreous and grasp it with the intraocular forceps. We can see that there is a small tear in the retina.
我们在周边玻璃体内定位到金属异物,并使用眼内镊子将其夹取。可见视网膜存在一处小裂孔。
5:05 We remove the foreign body and immediately close the sclerotomy.
移除异物后立即关闭巩膜切口。
6:00 We decided to leave the patient aphakic and can return to place a lens implant in the future if the eye is stabilized.
我们决定暂时保留患者无晶状体状态,待眼部情况稳定后可行人工晶状体植入术。