23 G无缝线玻璃体切割手术在治疗玻璃体视网膜疾病中的应用

Application of 23-gauge transconjunctival sutureless vitrectomy system in various vitreoretinal diseases

摘要:

目的：探讨23 G无缝线玻璃体切割手术治疗玻璃体视网膜疾病的疗效。方法：应用23 G无缝线玻璃体切割技术在接触式广角镜下对154例玻璃体视网膜疾病进行手术，观察手术疗效，术中及术后并发症，手术时间，手术前后视力及眼压变化。结果：①共134例154眼均顺利完成。②手术时间28~83 min，平均（42.0±5.2 ） min。③术后1、2、3月最佳矫正视力与术前对比均有所提高（n=154，具体P值见表1）。④术前与术后第1、3、7、30天眼压比较，术后第1天有较低和较高的眼压，术后3 d高眼压较多，术后7、30 d眼压稳定。⑤3例（1.9%）术后出现低眼压，15例（9.7%）高眼压，无眼内炎发生。结论：采用23 G无缝线玻璃体手术治疗玻璃体视网膜疾病，具有手术时间短、创伤小、并发症少、术后视力恢复快、 手术疗效确切的优点。

Abstract:

Objective：To discuss the efficacy of vitreoretinal surgery using 23-gauge transconjunctival sutureless vitrectomy（TSV） sys－tem for various vitreoretinal diseases. Methods：A total of 154 eyes of patients who underwent vitreoretinal procedures using 23-gauge minimally invasive surgery vitrectomy system in wide field retionscope were enrolled. Efficacy，intraoperative and postoperative compli－cations and operation time were observed. Moreover，intraocular pressure（IOP） and best corrected visual acuity（BCVA） of pre-and post-operation were determined. Results：①All operation were performed successfully. ②Mean duration of operation was （42.0±5.2） min（ranging from 28 min to 83 min）. ③BCVA was improved at 1，2，3 months after operation compared with that before operation. ④Compared with those before operation，both lower and higher IOP were observed on 1 d after operation，higher IOP was observed on 3 d after operation and steady IOP was found on 7 d and 30 d after the operation. ⑤3 eyes（1.9%） had ocular hypotensipon af－ter operation，15 cases（9.7%） had ocular hypertension and no case of endophthalmitis was reported. Conclusion：With the advantages of shorter operation time，less trauma，fewer complications，more convenient and rapid visual recover，23-gauge TSV system is effec－tive in the treatment of vitreoretinal diseases.