tailieunhanh - Hyperopia and presbyopia - part 8

Nếu vết mổ không song song, phân khúc có thể xoay trong vết rạch mất hầu hết các thang máy của nó. Chăm sóc cần được thực hiện để loại bỏ tất cả các viên nang mộng gần vết rạch để tránh một vết rạch cạn. Không mất định hình scleral, một phiến kính kim cương | 228 Phillips and Yee Figure 11 The 5-mm lamella diamond blade. parallel to each other not radial to the limbus. If the incisions are not parallel the segment may rotate within the incision losing most of its lift. Care should be taken to remove all of Tenon s capsule near the incision so as to avoid a shallow incision. Without losing scleral fixation a 5-mm-long lamella diamond blade Fig. 11 is placed in the incision located furthest from the scleral fixator. The diamond blade is slowly advanced through the sclera toward the other incision near the scleral fixator Fig. 12 . By observing the relative visibility of the lamella diamond blade through the sclera one controls the depth of the blade. The very tip of the diamond lamella blade should not be visible as the blade is passed through the sclera. Only a slight elevation or bulge of the sclera at the lateral edges of the blade should be seen. If the blade is easily Figure 12 The lamella diamond blade being used to make a scleral belt loop. Copyright Marcel Dekker Inc. All rights reserved. Marcel Dekker Inc. 270 Madison Avenue New York New York 10016 The Scleral Expansion Procedure 229 Figure 13 The thickness of the scleral belt loops and the exit wound are checked with the spatula. seen through the sclera then the loop is too shallow and the effect of the surgery will be greatly reduced. In making the scleral belt loop care should be taken not to retract and advance the blade unnecessarily to avoid making blind pockets that will increase the difficulty of passing the scleral expansion segment. On nearing the exit incision with the diamond blade the sclera is depressed with the scleral fixator to help open the exit incision. It is usually necessary to aim the lamella blade upward just before exiting to prevent a blind pocket under the exit incision. The entire lamella diamond blade is 5 mm long. The front curve of the blade is 1 mm long. Therefore by seeing the complete front curve of the .