改良两切口23G经结膜免缝合玻璃体切割系统硅油取出术的观察

目的：：评价一次性输血器和自制抽吸头用于23 G经结膜免缝合玻璃体切割系统硅油取出术的有效性和安全性。方法：将23 G灌注管在距离末端5 mm处剪断,制成抽吸头,用于连接一次性输血器和23 G穿刺套管。将输血器的莫菲氏管及以上部分剪除,连接玻璃体切割器的积液盒,利用玻璃体切割器的吸引系统通过睫状体平坦部的两切口主动抽吸清除眼内硅油。结果：患者132例手术中仅有13例(9.8%)需要缝合穿刺口,手术时间为7~28(平均15.1±6.2)min。术后早期107例(81.1%)患者眼压低于11mmHg,并有2例出现周边脉络膜隆起,术后1 wk 眼压基本恢复正常,但有2例(1.5%)高度近视合并黄斑裂孔性视网膜脱离患者出现视网膜再脱离。大部分患者硅油清除干净,仅有4例(3.0%)有少许硅油残留。结论：利用一次性输血器和自制抽吸头连接玻璃体切割器的吸引系统行两切口23 G经结膜免缝合硅油取出术具有安全、有效、快捷、经济等优点,值得推广应用。

Study of modified two incisions silicone oil removal with a 23G transconjunctival sutureless vitrectomy system

AIM:To evaluate the efficacy and safety of silicone oil removal with a 23G transconjunctival sutureless vitrectomy system linked disposable transfusion tube and self-made suction tip.

METHODS: The suction tip was made with a 23G infusion tube be cut from the end of the 5mm. It was used to connect the disposable transfusion tube and 23G puncture cannula. The disposable transfusion tube which was cut from the end of the MaiFei's pipe was connected with the effusion box of the vitreous cutter. Intraocular silicone oil was proactive suction and removed through two incisions on pars plana ciliaris with the vitreous cutter suction system.

RESULTS: Only 13 cases(9.8%)need suture puncture ports in 132 cases in the operation. Operation time was 7-28min. The average operation time was 15.1± 6.2min. In early postoperative, there were 107 cases(81.1%)appeared lower intraocular pressure(<11mmHg)and 2 cases appeared choroid detachment in 132 cases patients. Most of the patients recovered to normal but 2 case(1.5%)high myopia macular hole retinal detachment occurred recurrent retinal detachment 1wk after operation. Silicone oil was removed cleanly in the most patients, only 4 cases(3.0%)with a little silicone oil residue.

CONCLUSION: The surgery that silicone oil is removed through two incisions with a 23G transconjunctival sutureless vitrectomy system linked disposable transfusion tube and self-made suction tip has the advantages of safe, effective, fast, economic, and it is worthy of popularization and application in clinical.