标准三通道下23G免缝合切口联合18G套管针硅油取出术的临床应用研究

目的探讨标准三通道下23G免缝合切口联合18G套管针硅油取出术的临床疗效。方法对84例（87只眼）有晶状体眼行单纯硅油取出术,其中标准三通道下23G免缝合切口联合18G套针硅油取出术（简称23G组）43例（45只眼）,传统20G缝合切口硅油取出术（简称20G组）41例（42只眼）,记录两组手术时间,术后随访5-10个月,平均（8.5±2.5）个月,观察两组术后视力恢复、眼压变化和并发症情况,对相关记录进行统计分析比较。结果 23G组平均手术时间（16.65±0.66）min,显著性低于20G组（21.77±0.84）min,有统计学意义（P〈0.01）。术后两组最佳矫正视力相比较,无显著性差异（P〉0.05）。术后1 d 23G组眼压显著性低于20G组（P〈0.05）,术后1周、1个月23G组眼压与20G组比较无显著性差异（P〉0.05）。术后两组并发症发生情况无显著性差异（P〉0.05）。结论标准三通道下23G免缝合切口联合18G套管针硅油取出术时间短,能降低视网膜脱离等并发症的发生几率,该手术安全有效。

Application of three-channel 23G sutureless incision combined with 18G trocar to remove silicone oil after vit- rectomy

Objective To evaluate the outcomes of three-channel 23 G sutureless incision combined with 18 G trocar for silicone oil removal after vitrectomy. Methods Eighty-four patients（total 87 eyes） received either 23 G sutureless incision（45 eyes） or 20 G conventional suture（42 eyes） in order to remove vitreous silicone oil. The operation time was recorded. Patients were followed-up for 5 to 10 months,with the average follow-up period being 8. 5 ± 2. 5 months. Best corrected visual acuity（BCVA）,intraocular pressure,and postoperative complications were observed and compared between the two groups. Results The mean operation time was 16. 65 ± 0. 66 min in 23 G sutureless incision group,which was significantly less than that of 20 G conventional suture group（21. 77 ± 0. 84 min; P 〈0. 01）. There was no significant difference in best corrected visual acuity（BCVA） between the two groups. The intraocular pressure was significantly lower in 23 G group than in 20 G group（ P 〈0. 05） on day 1,but not at 1 week and 1 month after the surgery. There was no significant difference of postoperative complications in the two groups（ P〉 0. 05）. Conclusion Silicone oil removal by three-channel 23 G sutureless incision combined with 18 G trocar is time saving and causes less complications,for example,retinal detachment,after surgery. This technique is safe and effective.