23G玻璃体切除系统用于硅油取出的研究

目的评价23G经结膜无缝合玻璃体切除系统应用于Oxane5700硅油取出术的效果。方法回顾性分析连续病例68例（68只眼）临床资料，分为23G微创组（35只眼）和20G传统组（33只跟），两组进行比较。结果所有患眼均成功取出硅油，平均随访（5．61±1．24）个月。23G组和20G组手术时间差异有统计学意义（t=21．582，P=0．000）；术后1d23G组最佳矫正视力优于20G组，两组差异有统计学意义（F=5．308，P〈0．05）。术后1d两组平均眼压较术前均明显降低，两组差异有统计学意义（F=6．087，P〈0．05）。术后及随访期间，两组术后眼疼痛不适及结膜充血眼红外观差异有统计学意义（Z=-2．253，-3．628，P〈0．05）。结论23G与20G玻璃体切除系统行Oxane5700硅油取出术比较，前者手术操作时间短、术后眼部疼痛轻、眼红外观持续时间短及患者舒适度高，且术后并发症的发生率无明显差异，是种快速安全有效的微创手术方式。

Clinical research of silicone oil removal with a 23-Gauge vitrectomy system

Objective To investigate the effects of Oxane 5700 silicon oil removal with 23G transconjunctival sutureless vitrectomy system（23 G TSV）. Methods Sixty-eight eyes of 68 consecutive pa- tients undergoing Oxane 5700 silicone removal were collected, and were divided into 23G minimally invasive group （35 eyes）and 20G traditional group （33 eyes）. Results The silicone oil was removed successfully in all patients, the mean duration of follow-up was （5.61 ＋ 1.24） months. There were significant differences between 23G minimally invasive group and 20G traditional group in the mean operation time （t = 21. 582, P = 0. 000）. There were also significant differences between two groups in the wound opening time and closing time （ t = 28.681, t = 29. 720, P = 0. 000）. The best corrected visual acuity in 23 G minimally invasive group was better than that in 20G traditional group at one day after surgery, there was significant differences be- tween two groups（F=6. 087,P 〈0.05）. The intraocular pressure （IOP） at one day after surgery in both groups was lower than that of preoperative, there were significant differences between two groups （ F = 6. 087, P 〈 0.05）. During the operation and follow-up, there was significant differences between two groups in the median of days discomfort and conjunctival congestion of the eye（ Z = - 2. 253, - 3. 628, P 〈 0.05 ）. Conclusion The 23G TSV is a safe and effective surgical technique to remove Oxane 5700 silicone oil. Com- pared with traditional standard 20-gauge vitrectomy system surgery, it is time-saving with less red-eye ap- pearance look and high degree of comfort.