tailieunhanh - Ophthalmic Microsurgical Suturing Techniques - part 6

Phẫu thuật tái tạo mống mắt có thể được thực hiện chủ yếu hay thứ. Trong hầu hết các trường hợp quá nhiều thao tác iris nên thể tránh được việc sửa chữa ban đầu. Điều này giúp ngăn ngừa viêm mạnh mẽ và các biến chứng kh | Chapter 7 Trauma Suturing Techniques 69 Reconstructive iris surgery can be accomplished either primarily or secondarily. In most cases excessive iris manipulation should be avoided at the initial repair. This helps prevent vigorous inflammation and other complications. Iris repair can be performed once the eye is less inflamed as a separate surgery. Cataract formation either at the time of the initial trauma or postoperatively is a common complication and its treatement will depend on several factors including presence of intraocular foreign body anterior and or posterior synechiae vitreous in the anterior chamber retinal and or vitreous involvement corneal clarity zonular integrity and others. Every case should be independently assessed but as a general rule lens material in the anterior chamber must be removed. If the lens capsule is not ruptured cataract surgery should be delayed until the initial trauma related infloatation has subsided. Wound Leak Wound leak is a common post operative complication in ocular trauma. It is related to the quality of the first surgery repair tissue necrosis edema infection or an increase in IOP. The best course of action depends on each individual case resuturing topical and or systemic medications bandage contact lens tissue glue IOP lowering medications and or observation. With every technique there is always a risk of fistula forma-ti Other Complications Endopthalmitis Posttraumatic endophthalmitis is a sight-threatening condition occurring in approximately 4 to 8 of openglobe injuries 29 . It can be a devastating complication following o pen-globe injuries and the visual prognosis is related to the setting of injury rural settings have a worse prognosis rupture of the crystalline lens presence of foreign bodies type and size time between trauma and surgery positive intraocular cultures and the virulence of the microorganism 8 29 . Necrosis Necrosis of ocular and or intraocular contents is directly .