20G玻璃体切割结膜微创切口技术应用分析

目的 探讨20G玻璃体切割术(简称玻切)结膜微创切口技术临床应用的疗效.方法 回顾性分析76例76只眼应用20G结膜微创切口技术行玻切术治疗玻璃体视网膜疾病患者的临床资料.手术切口分为结膜微创切口组及常规玻切组.结膜微创切口组手术结束时不缝合球结膜切口及灌注系统巩膜穿刺口,仅缝合玻切头及光导纤维头巩膜切口.而常规玻切组则用8-0可吸收缝线8字缝合玻切头、光导纤维、灌注系统巩膜切口及对位缝合球结膜切口.术后平均随访2-4月.观察患者术后结膜充血及切口愈合情况、术后眼压情况、手术中操作时间.结果 结膜微切口组患者平均手术时间为49min,常规玻切组平均61min,差异具有统计学意义(P＜0.05).结膜微切口组术后14d及28d复查时可见患者手术区球结膜表面光滑,充血及水肿已消退,巩膜切口闭合良好,仅见一淡灰色斑点.结膜微切口组和常规玻切组术后眼压相比,差异无统计学意义(P＞0.05).结论 20G玻璃体切割术结膜微创切口术具有手术时间短、结膜伤口愈合快、并发症少等优点.     

23G微创玻璃体手术巩膜切口渗漏的预防研究

目的寻找一种无创、安全有效、简单的方法预防23G微创玻璃体手术后早期低眼压的发生。方法前瞻性对照研究。将2011年7月至2012年9月在徐州市眼病防治研究所行23G微创玻璃体手术的连续病例资料分为3组：术中无巩膜切口渗漏未予缝合为无渗漏组,有巩膜切口渗漏者按照随机数字表法分为瞬康胶组（用α-氰基丙烯酸烷基酯医用胶封闭伤口）、缝线组（用8-0缝线缝合巩膜切口）,每组30例。用卡方检验比较各组间术后早期低眼压的发生率,用秩和检验比较各组结膜充血程度、患者舒适度、最终随访视力的差异。结果３组术后1周内发生低眼压的情况：缝线组无低眼压发生,瞬康胶组、无渗漏组分别有1例（3%）、4例（13%）发生低眼压,３组差异具有统计学意义（χ2=6.291,P＜0.05）。３组患者在术后1 d（Z=9.917,P＜0.01）、3 d（Z=9.620,P＜0.01）、1周（Z=10.221,P＜0.01）时结膜充血程度差异具有统计学意义,无渗漏组最轻,缝线组最重。３组患者在术后3 d时术眼疼痛程度差异具有统计学意义（Z=12.502,P＜0.01）,无渗漏组最轻,缝线组最重。3组患者术后2个月时视力进行比较差异无统计学意义（Z=4.234,P＞0.05）。3组在术后2周、4周用超声生物显微镜检测均未发现切口内有纤维组织内生。结论应用α-氰基丙烯酸烷基酯医用胶或缝线封闭渗漏的巩膜切口能够有效地预防23G微创玻璃体手术后早期低眼压的发生。其中α-氰基丙烯酸烷基酯医用胶具有无创、安全有效、使用简便等优点。     

兔经结膜无缝线玻璃体切除术后巩膜切口愈合的实验研究

目的探讨兔经结膜无缝线玻璃体切除术后巩膜切口愈合的病理机制,并比较术中不同操作方法对巩膜切口愈合的影响。设计实验研究。研究对象新西兰白兔。方法32只新西兰白兔随机分为施行核心玻璃体切除联合气体眼内填充(A组)、核心玻璃体切除(B组)、次全玻璃体切除联合气体眼内填充(C组)和次全玻璃体切除(D组)。在术前、术后1d、3d、5d、7d和14d采用Tonopen眼压计记录眼压。术后1d、5d和9d使用超声生物显微镜观察巩膜切口愈合情况,术后3d、5d和9d切口组织学切片观察巩膜切口愈合过程。主要指标眼压、巩膜切口内外径值。结果术后1d,核心玻璃体切除联合气体眼内填充组的眼压显著高于其他3组(P<0.001)。术后5d起,4组眼压无差异。超声生物显微镜显示,兔巩膜切口愈合期为9天。术后1d,50.8%(17/ 31)兔眼玻璃体嵌顿于切口内口,31.3%兔眼结膜下出现气团(5/16),64.5%(20/31)结膜下出现液腔。术后1d A和B组切口内径明显小于C和D组(P<0.001)。4组切口外径无差异。术后1d的切口内外径均明显小于术时直径。巩膜切口组织学切片显示,巩膜切口愈合过程为肉芽肿样反应。结论兔经结膜无缝线玻璃体切除手术后巩膜切口愈合的病理机制是伴有巩膜组织弹性回缩的肉芽肿样反应。采用核心玻璃体切除联合气体眼内填充的操作方式术后切口渗漏最少。     

23G微创玻璃体切割手术巩膜切口的超声生物显微镜观察

常规20G玻璃体切割手术是治疗增生性糖尿病视网膜病变(PDR)的重要手段.近年来,微创玻璃体手术系统由于巩膜切口和手术器械直径较小,创伤小,恢复快而应用逐渐增多.但既往临床经验表明,若玻璃体手术巩膜切口愈合不良,发生玻璃体视网膜嵌顿可造成视网膜裂孔和视网膜脱离,严重者可发生前部增生性视网膜病变、睫状体脱离甚至眼球萎缩[1,2].因此,我们采用超声生物显微镜(UBM)对玻璃体切割手术后患者的巩膜切口进行了观察,现将结果报道如下.     

20G与23G玻璃体切割术临床应用比较

目的 比较20G自闭式巩膜隧道切口玻璃体切割手术与23G玻璃体切割手术治疗黄斑前膜的临床疗效.方法 随机选取21(21只眼)例黄斑前膜患者,10例(10只眼)行20G自闭式巩膜隧道切口玻璃体切割手术,11(11只眼)例行23G玻璃体切割手术.结果 20G自闭式巩膜隧道切口玻璃体切割手术组切口自行闭合率为93.3%,23G玻璃体切割手术组切口自行闭合率为100%,但两组差异无统计学意义(P>0.05).结论 选取合适病例使用20G自闭式巩膜隧道切口玻璃体切割手术,也可以实现切口无需缝合,且操作简捷、术后反应轻、恢复快,无需增加额外操作设备,具备与23G相似的优点,在无条件实施23G玻璃体切割手术时,是理想的替代术式.     

巩膜隧道切口在玻璃体切割术中应用

目的 :探讨巩膜隧道切口在玻璃体切割手术中的临床应用价值。方法 :收集本科同一医师所行玻璃体切割手术后复发视网膜脱离的 72眼 (其中行巩膜常规切口 5 0只眼 ,巩膜隧道切口 2 2眼 )进行统计学方差分析 ,比较行玻璃体切割常规切口组及巩膜隧道切口组中与切口玻璃体牵引有关的视网膜脱离复发率。结果 :行玻璃体切割常规巩膜切口的 5 0只眼中与切口牵引有关的复发视网膜脱离有 14眼 ( 2 8% ) ,而行巩膜隧道切口的 2 2眼中与切口牵引有关的复发视网膜脱离仅 1眼 ( 4 5 % )。第 2组中与切口牵引有关的视网膜脱离复发率远远低于第 1组 ( χ2 =5 0 96,P <0 0 2 5 )。结论 :巩膜隧道切口在玻璃体切割手术中的应用可明显降低与切口有关的视网膜脱离复发率 ,且具有诸多术中优势 ,故有较高的临床应用价值。     

骨性巩膜钉封闭玻璃体切除术后巩膜创口实验观察

目的探讨骨性巩膜钉用于封闭玻璃体切除术后巩膜创口的效果。方法将30只新西兰白兔分为实验组和对照组,每组15只。每组再根据观察时间（术后1、2、4周,3、6个月）分别分为5个亚组,每个亚组3只。玻璃体切除术后,实验组用骨钉封闭兔眼玻璃体巩膜创口,对照组用8-0可吸收缝线缝合,比较两组手术时间,肉眼观察两组兔的眼部表现,定期处死动物后取出术眼行常规病理检查。结果实验组平均手术时间为15．6min,对照组16．73min,差异有统计学意义（P〈0．05）。术后l周时,两组出现程度大致相同的球结膜和浅层巩膜充血,角膜保持清亮;2周时,实验组球结膜和浅层巩膜充血较对照组轻;6个月时,实验组眼部无明显反应,而对照组仍可见局部充血。组织学显示：术后早期两组呈现程度大致相同的炎性坏死反应;而后实验组炎性反应较对照组减轻得快;6个月时,实验组炎性细胞浸润进一步减少,而对照组无明显改变。结论骨性巩膜钉制作简单、植入方便、组织相容性良好,用于封闭玻璃体切除术后巩膜创口具有良好前景。     

23G与25G＋微创玻璃体切除术治疗玻璃体积血的临床对比观察

目的：对比观察23G、25G＋经结膜免缝合玻璃体切除术（TVS）治疗玻璃体积血的安全性和有效性。方法对比分析2013年3月至2014年3月因玻璃体积血在我院行两种不同微创玻璃体切除术（23G和25G＋）患者的临床资料,采用t检验或秩和检验以及χ2检验对比观察手术时间、切口闭合情况、术后眼压、术后视力及并发症等。结果共计45例（47只眼）,其中21例（22只眼）行23G微创玻璃体切除患者术（23G组）,24例（25只眼）行25G＋微创玻璃体切除术（25G＋组）;23G组手术时间为35～94 min,平均55．4 min;25G＋组手术时间为30～85 min,平均47．6 min;差异无统计学意义（ P ＝0．105）。23G组、25G＋组手术切口自然闭合比率分别为45．5％、80．0％,缝合率分别54．5％、20．0％,差异有统计学意义（ P ＝0．018）。术后第1天23G组眼压为（9．1±3．8） mm-Hg,25G＋组眼压为（10．2±2．6）mmHg,差异无统计学意义（ P ＝0．712）,术后第3天23G组眼压为（10．3±4．1） mmHg,25G＋组眼压为（10．9±3．7）mmHg,差异无统计学意义（ P ＝1．000）,术后1周23G组眼压为（14．3±6．9） mmHg,25G＋组眼压为（15．7±6．3）mmHg,差异无统计学意义（ P ＝0．371）;23G组术后视力改善情况与25G＋组无统计学差异（ P ＝0．807）;23G组术后发生视网膜脱离1例,切口渗漏1例,复发玻璃体积血3例;25G＋组术后发生视网膜脱离2例,切口渗漏2例,复发玻璃体积血1例;两组发生率差异均无统计学意义（ P ＝1．000、1．000、0．328）。结论25G＋TVS与23G TVS均是有效的玻璃体积血治疗方法,25G＋TVS切口自然闭合率更好,其他并发症发生率无差异。     

玻璃体切除联合超声乳化术巩膜穿刺口UBM临床分析

目的 通过UBM对比观察单纯玻璃体切除和玻切联合超声乳化术后巩膜穿刺口的愈合情况,分析联合手术是否可以减少巩膜穿刺口玻璃体增殖条索的形成.方法 UBM 检查巩膜穿刺口的愈合情况共分为4级,0级,无玻璃体嵌顿;1级,穿刺口内可见玻璃体嵌顿;2级,玻璃体嵌顿并形成同穿刺口相连的增殖条索;3级,出现牵拉性视网膜脱离或存在视网膜组织嵌顿.对30例单纯玻璃体切除手术和20例联合超声乳化手术后行UBM检查巩膜穿刺口的愈合情况,对检查结果进行x2检验,分析两组之间巩膜切口愈合情况的差异.结果 在单纯玻切手术组:0级、1级切口愈合17例,占56.7%;2级、3级切口愈合13例,占43.3%.联合超声乳化组:0级、1级切口愈合17例,占85.0%;2级愈合3例,占15.0%,无3级愈合病例.单纯玻切手术组术后巩膜切口发生玻璃体嵌顿并产生增殖牵拉的病例数明显高于联合手术组,差异有统计学意义(P<0.05).结论 玻璃体切除联合超声乳化手术可以减轻术后巩膜穿刺口的玻璃体嵌顿.     

超声生物显微镜在儿童白内障25G扁平部前段玻璃体切割术后的应用

目的应用超声生物显微镜(ultrasound biomicroscopy,UBM)观察儿童白内障25G扁平部前段玻璃体切割术后穿刺口的愈合过程及特点。方法行25G无缝线扁平部前段玻璃体切割术的儿童先天性白内障7例(11眼),观察切割时间、术中术后临床效果、术后穿刺口渗漏、眼压变化、并发症和穿刺口UBM影像学征象。结果所有患儿平均切割时间为(40.9±8.4)s。术中玻璃体波动小,术后炎症反应轻、恢复快,无严重并发症发生,术后巩膜穿刺口无明显渗漏。患儿眼压平稳,术前(13.41±3.44)mmHg(1kPa=7.5mmHg)与术后1d(13.77±4.47)mmHg、1周(13.11±3.20)mmHg、1个月(13.39±2.55)mmHg相比较,差异均无统计学意义(均为P>0.05)。UBM影像学检查显示术后3d巩膜穿刺口部位可见贯穿巩膜及睫状体扁平部的连续低回声缝隙;术后7d缝隙明显缩小;术后2周穿刺口内口已愈合;术后3周8眼(72.7%)已不能检测到扁平部穿刺口;术后4周所有穿刺口完全愈合。结论通过UBM观察到儿童25G无缝线扁平部前段玻璃体切割术后巩膜穿刺口的恢复迅速、愈合良好,未见切口渗漏及玻璃体嵌...     

Incidence of complications in 25-gauge transconjunctival sutureless vitrectomy based on the surgical indications.

BACKGROUND AND OBJECTIVE: The complications of 25-gauge transconjunctival sutureless vitrectomy based on the surgical indications were reviewed. PATIENTS AND METHODS: Thirty-eight patients underwent 25-gauge transconjunctival sutureless vitrectomy. Indications for vitrectomy, preoperative and postoperative best-corrected visual acuity, preoperative and postoperative intraocular pressure, and any intraoperative or postoperative complications were recorded. RESULTS: Complications included the need to suture a leaking sclerotomy intraoperatively in four eyes (9%), all of which involved oil removal; postoperative hypotony with choroidals in two eyes (5%); mild progression of nuclear sclerotic cataract in one eye (2% of all eyes, 4% of phakic eyes); the need to switch to 20-gauge pars plana vitrectomy in one eye (2%); corneal abrasion in one eye (2%); and retinal detachment in one eye (2%). Sclerotomy leakage and hyopotony with choroidals were only encountered in cases involving previously vitrectomized eyes, whereas none of the eyes without previous vitrectomy had leakage-related complications. CONCLUSIONS: Previously vitrectomized eyes have a higher incidence of complications related to postoperative leakage, possibly due to the lack of plugging effect of peripheral vitreous on the unsutured sclerotomy. One should consider suturing any leaking sclerotomy at the conclusion of surgery involving previously vitrectomized eyes.     

Examination of Self-Sealing Sclerotomy for Vitrectomized Eye under Gas Tamponade in 23-Gauge Transconjunctival Sutureless Vitrectomy

Introduction: To investigate whether a previous history of vitrectomy affects sclerotomy self-sealing under gas tamponade in 23-gauge transconjunctival sutureless vitrectomy. Materials and Methods: This study retrospectively reviewed two groups, a vitrectomized group (seven consecutive cases) and an initial vitrectomy group (82 consecutive cases), who underwent 23-gauge transconjunctival sutureless vitrectomy at Jikei University School of Medicine Daisan Hospital in Tokyo. Factors affecting sclerotomy self-sealing were examined using multiple regression analysis. The criterion variable was massage time, and independent variables were age, surgical time, axial length, vitreous incarceration, history of vitrectomy, preoperative intraocular pressure (IOP), and postoperative IOP. Results: Age (F?=?10.4) was the only significant factor. History of vitrectomy was not a significant factor (F?=?0.06). Conclusions: Previous history of vitrectomy does not affect sclerotomy self-sealing under gas tamponade in 23-gauge transconjunctival sutureless vitrectomy.     

Tissue glue in sutureless vitreoretinal surgery for the treatment of wound leakage.

BACKGROUND AND OBJECTIVE: To assess the surgical outcomes of the use of tissue glue to close sclerotomy sites when required and the views of ultrasound biomicroscopy of the sclerotomy sites in 23- and 25-gauge vitrectomy systems. PATIENTS AND METHODS: A 25-gauge transconjunctival sutureless vitrectomy was performed in 38 eyes and a 23-gauge transconjunctival sutureless vitrectomy was performed in 46 eyes for various vitreoretinal diseases. Wound leakage occurred at the sclerotomy sites at the end of the surgery in 6 eyes with 23-gauge transconjunctival sutureless vitrectomy and 7 eyes with 25-gauge transconjunctival sutureless vitrectomy. The sclerotomy sites were closed by using tissue glue to prevent wound leakage and evaluated with ultrasound biomicroscopy postoperatively. RESULTS: No wound leakage was observed at the end of the surgical procedure or during the follow-up period. Abnormal fibrous ingrowth was not detected at the sclerotomy sites by means of ultrasound biomicroscopy. CONCLUSION: The results demonstrated the efficacy of tissue glue for closing site ports when wound leakage is observed in transconjunctival sutureless vitreoretinal surgery.     

Ultrasound biomicroscopy study of direct and oblique 25-gauge vitrectomy sclerotomies

PURPOSE: To study 25-gauge sclerotomy healing process in vivo with ultrasound biomicroscopy (UBM) in direct and oblique incisions. DESIGN: Prospective interventional case series report. METHODS: At our institution, we performed UBM studies on 53 sclerotomies during the first 30 days after 25-gauge vitrectomy, looking for conjunctival bleb development, sclerotomy healing signs, and vitreous incarceration in the wound. RESULTS: Echographical healing signs were completed in 77% of patients by day 15 with no differences between direct and oblique sclerotomies. By day 30, all but one sclerotomy were closed. Conjunctival blebs developed over 64% of direct sclerotomies, and 25% of oblique (P = .0059), but all resolved spontaneously by day 15. Vitreous incarceration appeared in 72% of sclerotomies. CONCLUSIONS: Twenty-five gauge sclerotomies heal by day 15 in most cases with no difference between direct and oblique sclerotomy construction. Conjunctival blebs developed more frequently over direct than oblique sclerotomies.     

Comparison of 25-gauge sutureless vitrectomy and 20-gauge vitrectomy in the treatment of posterior capsule opacification in pseudophakic children

AIM: To compare the effectiveness and safety of pars plana capsulotomy and vitrectomy using 25-gauge tansconjunctival sutureless vitrectomy system and 20-gauge vitrectomy system for posterior capsule opacification (PCO) in pseudophakic children. METHODS: Retrospectively study. Pars plana capsulotomy and vitrectomy using 25-gauge sutureless vitrectomy system was performed for PCO in the study group (32 eyes). Patients in the control group (34 eyes) underwent capsulotomy and vitrectomy using standard 20-gauge vitrectomy system, providing a comparison between 2 groups with regard to preoperative and postoperative best corrected visual acuity (BCVA), intraocular pressure (IOP), and intraoperative and postoperative complications. The two groups were performed consequentially. The patients ages ranged from 2 to 13y (means: 6.61±2.73y). Surgical technique, intraoperative and postoperative complications, visual acuity, IOP, and recurrent PCO were recorded. RESULTS: The surgical procedure was performed uneventfully in all patients. Visual acuity improved significantly in both groups. BCVA improved in 22 eyes (81.5%) in the study group and in 28 eyes (87.5%) in the control group. There was no statistical difference of visual acuity that were attainable in two groups (H=0.115, P=0.909). Mean postoperative IOP showed no significant difference between the groups at 1wk. All sort of PCO were accomplished by 20-gauge system, while 25-gauge system was effective for pearls style and 2 grade of fibrous PCO, and was insufficient to grade 3 of PCO. In the study group two cases were not accomplished by 25-gauge system while 20-gauge system conquered them. Compared with the control group, mean operative time for opening and closing the sclerotomy in the study group was considerably reduced. The mean follow-up was 38.2mo (range: 8-79mo). During the follow-up period, no incision leakage, corneal edema, vitreous loss, IOL damage, retinal detachment, recurrent PCO, or other complications were noted. CONCLUSION: Pars plana capsulotomy and vitrectomy using 25-gauge transconjunctival sutureless vitrectomy appeared to be a safe and effective approach for PCO in pseudophakic children. Combined sutureless surgery needed shorter setup time for sclerotomy and caused less surgical trauma than combined surgery with 20-gauge vitrectomy. Therefore, this type of procedure would be a good option for selected cases with PCO in pseudophakic children.     

Comparison of clear corneal phacoemulsification combined with 25-gauge transconjunctival sutureless vitrectomy and standard 20-gauge vitrectomy for patients with cataract and vitreoretinal diseases

PURPOSE: To compare effectiveness and outcomes of clear corneal phacoemulsification combined with 25-gauge transconjunctival sutureless vitrectomy and standard 20-gauge vitrectomy system for patients with clinically significant cataract and vitreoretinal diseases. SETTING: Department of Ophthalmology, Tri-Service General Hospital, Taipei, Taiwan, Republic of China. METHODS: Clear corneal phacoemulsification combined with 25-gauge transconjunctival sutureless vitrectomy was performed in the study group (15 eyes). Patients in the control group (15 eyes) had combined surgery with clear corneal phacoemulsification and the existing 20-gauge vitrectomy system, providing a comparison between 2 groups with regard to preoperative and postoperative best corrected visual acuity (BCVA), intraocular pressure, and intraoperative and postoperative complications. The additional outcome measurements in both groups were duration of the surgical procedures, time to return to preoperative corneal clarity, time to achieve stable vision, and subjective ocular irritation postoperatively. RESULTS: Postoperatively, BCVA improved in 12 eyes (80%) in the study group and in 11 eyes (73.3%) in the control group. Mean operative time for opening and closing the sclerotomy was significantly greater in the control group than in the study group. Time to return to preoperative corneal clarity and time to achieve stable vision showed no significant difference between the groups. Compared with the control group, postoperative ocular irritation in patients in the study group was considerably reduced. CONCLUSIONS: Combined sutureless surgery needed shorter setup time for sclerotomy and caused less postoperative ocular irritation than combined surgery with 20-gauge vitrectomy. Therefore, this type of procedure would be a good option for selected cases with cataract and vitreoretinal diseases.     

Illuminated curved 25-gauge vitrectomy probe for removal of subsclerotomy vitreous in vitreoretinal surgery

Incarceration of vitreous in sclerotomy sites during pars plana vitrectomy can lead to wound-related complications similar to vitreous incarceration in cataract surgery. We describe an illuminated curved 25-gauge vitrectomy probe for removing vitreous from sclerotomy sites. Polyester tubing is used to secure a fiber optic endoilluminator (0.5 mm) with the curved 25-gauge vitrector (0.5 mm). The resultant illuminated curved vitrector (20 G) has a diameter of 1.0 mm. It facilitates complete removal of vitreous around the internal sclerotomies under direct visualization in both phakic and pseudophakic eyes. The same was confirmed with ultrasound biomicroscopy of the sclerotomy sites. Curved vitrector reduces postoperative complications related to incarcerated vitreous in phakic and pseudophakic eyes and other sclerotomy-related wound complications.     

Oblique sclerotomy technique for prevention of incompetent wound closure in transconjunctival 25-gauge vitrectomy

PURPOSE: To develop a surgical incisional technique that helps overcome incompetent sclerotomy closure previously reported in sutureless 25-gauge vitrectomy. DESIGN: Prospective interventional case series report. METHODS: We performed this surgical technique in 12 eyes of 12 consecutive patients scheduled for 25-gauge vitrectomy. The sclerotomy was created performing an oblique incision, a structural modification that helps the closure stay watertight once the cannulas are removed. RESULTS: This technical variation resulted in no intraoperative leakage after cannula removal in any of the 36 sclerotomies performed. CONCLUSIONS: Incision construction using this technique may resolve the reported sclerotomy leakage that in some cases had to be solved by suturing.     

27G微创玻璃体切除手术的发展及应用

自二十世纪初25 G、23 G无缝线玻璃体切除术的相继推出,已将我们带入玻璃体视网膜手术的微创时代约有10余年历史。与传统20 G三通道玻璃体切除术相比,25 G、23 G无缝线微创玻璃体切除术不仅缩小巩膜切口,而且还大大简化了手术程序,缩短了手术时间及降低了手术并发症。因此,在过去十余年时间里,越来越多的医生由传统的20 G玻璃体切除术转向25 G、23 G玻璃体切除术。但随着微创玻璃体切除术的普及,无缝线巩膜切口的相关并发症也随之增多。本着“越小越好”的理念,眼科学者开始研究下一代玻切手术,并且得益于不断更新换代的高速玻切机、高通量的照明光源、更精细的制造技术和清晰广角镜的发展,日本学者Oshima于2010年正式推出了27G玻璃体切除术。27 G玻璃体切除术较之前的微创玻璃体切除术切口更小,切割速率更高,带给眼底外科医生全新的体验。目前27 G甚至更细的玻璃体切除术尚处在继续革新之中,围绕其优缺点、适应证及未来发展也逐渐成为大家关注讨论的焦点。本文在此结合笔者27 G玻璃体切除术经验,对27 G微创玻璃体切除术玻璃体切除术进行了一个简要的综述。