23-G与20-G玻璃体切割术对视网膜脱离的临床疗效分析

目的 分析23-G与20-G玻璃体切割术对视网膜脱离的临床疗效。方法 115例视网膜脱离患者分别接受23-G微创玻璃体切割术（A组，52例52眼）和20-G玻璃体切割术（B组，63例63眼）。记录手术时间和术中并发症的发生情况，术后随访6~15个月，观察术后视网膜复位、视力（logMAR视力)及并发症的发生等情况，对相关记录指标进行统计学分析比较。结果 A组和B组的手术时间分别为（67±18）min和（70±19）min，组间比较差异无统计学意义（P>005）；术中主要并发症为医源性裂孔，A组为2眼，B组为3眼。术后末次随访结果显示：A组视网膜复位49眼（复位率942%），logMAR视力提高0.337±0.046；B组视网膜复位59眼（复位率93.7%），logMAR视力提高0.367±0.052；两组间视网膜复位率和视力提高幅度比较，差异均无统计学意义（P>0.05）。结论 23-G与20-G玻璃体切割术对视网膜脱离的临床疗效相近，23-G微创玻璃体切割术适用于各种视网膜脱离患者的治疗。

Outcome analysis of 23-G vitrectomy versus 20-G vitrectomy for treatment of retinal detachment

Objective To analyse the outcomes of 23-G vitrectomy and 20-G vitrectomy for the treatment of retinal detachment.Methods One hundred and fifteen patients(115 eyes) with retinal detachment were enrolled,and were treated with 23-G minimally invasive vitrectomy(group A,52 patients,52 eyes) or 20-G vitrectomy(group B,63 patients,63 eyes).The duration of operation and occurrence of complications during operation were recorded.Patients were followed up for 6 to 15 months after operation,the occurrence of retinal reattachment,visual acuity(logMAR visual acuity) and occurrence of complications were observed.The related parameters were statistically analysed and compared.ResultsThere was no significant difference in the duration of operation between group A and group B [(67±18) min vs(70±19)min,P>0.05].The main complication during operation was iatrogenic retinal hole,with 2 eyes in group A and 3 eyes in group B.The last follow-up revealed that there were 49 eyes with retinal reattachment in group A(reattachment rate,94.2%),and logMAR visual acuity increased 0.337±0.046.There were 59 eyes with retinal reattachment in group B(reattachment rate,93.7%),and logMAR visual acuity increased 0.367±0.052.There was no significant difference in retinal reattachment rate and degree of visual acuity increase between two groups(P>0.05).Conclusion 23-G vitrectomy and 20-G vitrectomy may yield similar outcome for treatment of retinal detachment,and 23-G minimally invasive vitrectomy can be applicable for treatment of various vitreoretinal diseases with retinal detachment.