23G微创玻璃体切割术在玻璃体视网膜疾病中的应用

摘要/Abstract

摘要：

目的：探讨23G 经结膜无缝合玻璃体切割系统在玻璃体视网膜疾病中的应用，观察其疗效以及并发症情况。方法：回
顾性分析2011 年10 月至2013 年10 月行23G 玻璃体切割术的患者46 例（48 眼）。其中，特发性黄斑裂孔8 眼（16.7%），特发性黄斑前膜5 眼（10.4%），玻璃体积血19 眼（39.5%），糖尿病视网膜病变V-VI 期8 眼（16.7%），孔源性视网膜脱离8 眼（16.7%）。分别观察缝合组和未缝合组手术前和手术后1d、7d、1 个月眼压变化情况、手术效果、时间、最佳矫正视力及术中、术后并发症等。术后随访1~12 个月。结果：所有病例均顺利完成手术，巩膜切口缝合组和未缝合组间术后1d、7d、1 个月眼压差异均无统计学意义（P>0.05）；术后最佳矫正视力均有不同程度提高，与术前比较差异有统计学意义（P< 0.01）。手术时间70.12±7.86 min；术后眼部刺激症状轻微，术后并发症少见。术中2 眼套管滑脱，5 眼结膜下轻微出血，3 眼结膜下气泡，所有病例在随访期间无严重并发症发生。结论：23G 玻璃体切割术具有微创、手术时间短等优点，术后恢复快，疗效好，并发症少，将其应用于治疗玻璃体视网膜病变是一种安全有效的微创手术方法。

关键词: 23G, 微创, 玻璃体切除术, 玻璃体视网膜疾病

Abstract:

Objective: To investigate the application of 23-gauge transconjunctival sutureless vitrectomy system（23-GTVS）in the
treatment of vitreoretinopathy disease and evaluate the efficacy,safety and complications. Methods: A 48 cases of 23-GTVS in our hospital from October 2011 to October 2013 was conducted retrospective analysis,including 8 eyes of idiopathic macular hole（16.7%）, 5 eyes of idiopathic macular epiretinal membrane（10.4%）,19 eyes of vitreous hemorrhage（29.5%）, 8 eyes of peripheral diabetic retinopathy（PDR stage V-VI）（16.7%）and8 eyes of rhegmatogenous retinal detachment（RRD）（16.7%）.Intraocular pressure preoperative as well as 1 day,7 days and 1 month postoperative, surgical effects, surgical time, best corrected visual acuity and complications were observed both in suture group and non-suture group. The follow-up time was from 1 month to 12 months. Results:
All cases were successfully completed operation and there were no statistical differences in intraocular pressure of different time points between two group（P>0.05）. Best corrected visual acuities postoperative both improved in two groups（P<0.01）. The mean surgery time was 70.12±7.86 min and there was few complication found. The intraoperative complications included 2 cases of slippage of intubation tube in,5 cases of slight hemorrhage under conjunctiva and 3 cases of bubble under conjunctiva.No serious postoperative complication was observed during the follow-up time in all cases. Conclusion: 23-GTVS, showing shorter operative-time,faster postoperative recovery,better curative effect and rare complications, was an effective and safe surgical technique in the management of vitreoretinopathy disease.

Key words: 23-gauge, micro-invasive, vitrectomy, vitreoretinopathy

中图分类号:

R774.1

段直光, 俞丽云, 陈银朝, 贾云琴, 莫逆. 23G微创玻璃体切割术在玻璃体视网膜疾病中的应用[J]. J4, 2014, 13(2): 47-51.

DUAN Zhi-Guang, YU Li-Yun, CHEN Yin-Chao, JIA Yun-Qin, MO Ni. Application of 23-gauge Micro-invasive Vitrectomy for Vitreoretinopathy Disease[J]. J4, 2014, 13(2): 47-51.

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