25+微创玻璃体视网膜手术治疗孔源性视网膜脱离的临床观察

目的 研究25+微创玻璃体视网膜手术治疗孔源性视网膜脱离的临床效果。 方法 回顾性分析孔源性视网膜脱离患者52例(52眼),治疗组(n=26)行25+微创玻璃体视网膜手术,对照组(n=26)行23G微创玻璃体视网膜手术。分析两组患者手术时间、术后视力、眼压、并发症和视网膜复位情况。 结果 与对照组比较,治疗组手术时间缩短(P<0.05);术后3 d及术后7 d,两组患者眼压较术前均升高,最佳矫正视力的最小分辨角对数均降低(P<0.05);术中治疗组并发症发生率(15.38%)低于对照组(42.31%)(P<0.05);术后治疗组低眼压发生率(3.85%)低于对照组(30.77%)(P<0.05);治疗组视网膜复位率(92.31%)与对照组(88.46%)比较差异无统计学意义(P>0.05)。 结论 25+与23G微创玻璃体视网膜手术治疗孔源性视网膜脱离的临床效果相当,但25+微创玻璃体视网膜手术能有效减少术中并发症及术后低眼压的发生,具有更高的安全性。

Clinical observation of 25-gauge minimally invasive vitreous retinal surgery for treatment of rhegmatogenous retinal detachment.

Objective To investigate the clinical effect of 25-gauge minimally invasive vitrectomy for treatment of rhegmatogenous retinal detachment. Methods This was a retrospective analysis of 52 patients with retinal detachment treated in our hospital. Patients were divided into treatment and control groups(n=26 each). The treatment group was treated with 25+ minimally invasive vitrectomy, and the control group was treated with 23G minimally invasive vitrectomy. The two groups were followed up for at least 3 months. The following parameters were evaluated: duration of the procedure, postoperative visual acuity, intraocular pressure, complications, and retinal restoration. Results The duration of the procedure in the treatment group was significantly shorter than that in the control group(P<0.05). Three and seven days following the operation, the intraocular pressure in both groups increased significantly. The postoperative logarithm of the minimum angle of resolution(LogMAR)visual acuity was significantly lower than the preoperative value(P<0.05). The incidence rate of complications in the treatment group was 15.38%, which was significantly lower than that in the control group(42.31%; P<0.05). The incidence rate of intraocular hypotension in the treatment group(3.85%)was significantly lower than that in the control group(30.77%)(P<0.05). There were no statistically significant differences in the retinal replacement rates between the treatment and control groups(92.31% and 88.46%, respectively; P>0.05). Conclusion Both 25-gauge and 23G minimally invasive vitrectomy have similar effectiveness in the treatment of rhegmatogenous retinal detachment, but the former is safer and is associated with a lower risk of postoperative complications and intraocular hypotension.