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| 传统20G与微创23G玻璃体切割术治疗视网膜脱离的早期疗效 |
| A initial comparative study on 23G vs 20G vitrectomy for treatment of retinal detachment |
| 投稿时间：2015-03-12 修订日期：2015-05-17 |
| DOI：10.3969/j.issn.1000-0399.2015.010.009 |
| 中文关键词: 玻璃体切除术 视网膜脱离 疗效 |
| 英文关键词: Vitrectomy Retinal detachment Effect |
| 基金项目: |
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| 中文摘要: |
| 目的 比较23G微创玻璃体切除术和20G传统玻璃体切割术治疗孔源性视网膜脱离的早期(术后3 d)临床疗效。方法 采用临床病例对照研究,对2012年10月至2014年10月就诊的38例(38只眼)孔源性视网膜脱离患者行玻璃体切割术,其中行23G玻璃体切割术20例(20只眼)为23G组,行20G玻璃体切割术18例(18只眼)为20G组,记录手术时间和术中并发症的发生情况。术后观察眼压、最佳矫正视力、是否发生二次网脱及眼内炎等并发症。将最佳矫正视力转化为最小视角对数(logMAR)视力进行统计分析。结果 23G组和20G组的手术时间差异有统计学意义(P<0.05)。术中主要并发症为医源性裂孔,其中23G组为1眼,20G组为1眼,差异无统计学意义(P>0.05)。两组术后第1天眼压差异有统计学意义(P<0.05),术后第2、3天两组患者眼压差异无统计学意义(P>0.05)。23G组术后3 d平均logMAR视力逐步提高,3个时间点分别为2.56±0.56、1.98±0.55、1.71±0.38,术后第2、3天视力与术前相比差异有统计学意义(P均<0.05),20G组术后3 d平均logMAR视力也逐步提高,3个时间点分别为2.65±0.76、2.03±0.51、1.92±0.46,术后第2、3天两组之间视力差异有统计学意义(P<0.05),与术前比较,两组视力分别在术后第2、3天明显提高,差异均有统计学意义(P均<0.05),术后第3天23G组视网膜均成功复位,20G组视网膜有1例未成功复位,两组均无眼内炎情况的发生,差异均无统计学意义(P>0.05)。结论 23G与20G玻璃体切割术治疗孔源性视网膜脱离的早期临床疗效相近,但在术后早期视力方面,23G玻璃体切除术显示出更好的优越性。 |
| 英文摘要: |
| Objective To compare the clinical efficacy of 23G and 20G vitrectomy (3 days after surgery) in initial treatment of retinal detachment. Methods Clinical case-control study was performed in 38 cases (38 eyes) with retinal detachment who underwent vitrectomy from October 2012 to October 2014 in our hospital, in which 23G vitrectomy was carried out in 20 cases (20 eyes) for 23G group, while 20G vitrectomy in 18 cases (18 eyes) for 20G group, then the operative time and incidence of intraoperative complications were recorded. Postoperative IOP, best corrected visual acuity, whether the occurrence of secondary detachment, and complications like endophthalmitis were observed after the operation. The best corrected visual acuity was transformed to the minimum viewing angle logarithm (logMAR) visual acuity for statistical analysis. Results The difference in the operative time of 23G group and 20G group was statistically significant (P<0.05). The main complication was iatrogenic retinal breaks, with one eye in 23G group and one eye in 20G group, and the difference was not statistically significant (P>0.05). IOP of 20G group after 1d of operation was higher than that of 23G group, (15.82±8.12) mmHg vs (11.63±5.41) mmHg, and the difference was statistically significant (P<0.05), but the difference in IOP after 2d, 3d of operation between the two groups was not statistically significant (P>0.05). 3d average postoperative logMAR visual acuity in 23G group was gradually improved, and the three time point was 2.56±0.56,1.98±0.55,1.71±0.38, respectively; 2 d, 3 d visual acuity had statistically significant difference compared with that of the preoperative (P<0.05). The mean logMAR visual acuity of 20 G group after three days was gradually increased, and the three time point was 2.65±0.76,2.03±0.51,1.92±0.46, respectively; 2 d, 3 d visual acuity had statistically significant difference compared with that of the preoperative (P<0.05); postoperative 2 d, 3 d vision had statistically significant difference(P<0.05). On 3d, 20G group had one case of unsuccessful retinal reset, endophthalmitis occurred in no case, and the difference was not statistically significant (P>0.05). Conclusion 23G and 20G vitrectomy have similar clinical efficacy in the initial treatment of retinal detachment, but in the early postoperative intraocular pressure and visual aspects, 23G shows superiority. |
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