23G微创玻璃体切割技术在临床中的应用

目的:探讨23G微创玻璃体切割技术在临床中的应用价值。方法:回顾23G微创玻璃体切除术治疗的玻璃体视网膜疾病患者140例140眼,随访1mo记录手术方式、术中情况、手术时间、手术效果、视力、眼压、手术并发症及角膜内皮密度。结果:(1)初次手术成功率100%,1mo复发率为0.71%,随访期间未发现感染性眼内炎及持续性切口渗漏等并发症;(2)手术时间20～95(平均46min);(3)住院时间3～39(平均7)d;(4)91.43%患者术后视力较术前有不同程度提高,最佳矫正视力为0.7,术前、术后视力比较有显著性差异(P<0.01);(5)眼压:术后1d眼压与术后5d相比,差异有显著统计学意义(P<0.01);术后1d眼压与术后1mo相比,无统计学差异(P>0.05);术后5d与术后1mo相比,有统计学差异(P<0.05);(6)角膜内皮密度(个/mm2):术前2735.49±319.28,术后1mo2694.14±354.08,无统计学差异(P>0.05)。结论:23G微创玻璃体切割技术具有手术时间短、术后恢复快、手术并发症少、应用范围广等优点,临床应用前景好。

Clinical application of 23-gauge transconjunctival vitrectomy sutureless system

AIM: To investigate the clinical application value of 23-gauge transconjunctival vitrectomy sutureless system(23G TSV).

METHODS:Totally, 140 patients(140 eyes)with vitreous retinal diseases underwent 23G TSV. During one month of follow-up, the operation method, operation time, operation effect, visual acuity, intraocular pressure, corneal endothelium and operation complication were recorded.

RESULTS:(1)The initial operation success rate was 100%, the recurrence rate in one month was 0.71%. There had no infectious endophthalmitis or persistent incision leakage and other complications during the follow-up period;(2)The operation time was 20-95 minutes, the average was 46 minutes;(3)The length of the hospitalized time was 3-39 days, the average was 7 days;(4)The visual acuity was improved in 91.43% patients, the best-corrected visual acuity was 0.7, and the differences between preoperative and postoperative visual acuity was significant(P<0.01);(5)intraocular pressure(IOP/mmHg): The rate of low intraocular pressure(<7)was 7.14% before operation, 5%, 0.71% and 0.71% at 1, 5 days and one month after surgery, respectively; The rate of high intraocular pressure(>21)was 4.29% before operation, 4.29%, 12.14% and 5% at 1, 5 days and one month after surgery, respectively. The differences between preoperative and postoperative was significant(P<0.05);(6)The corneal endothelial density(/mm²): The result of preoperatively corneal endothelial density was 2 735.49±319.28, and after a month the corneal endothelial density was 2 694.14±354.08, the difference had no significance(P>0.05).

CONCLUSION: Because of the short operation time, rapidly postoperative recovery, less operation complications and the advantages of wide application range, 23G minimally invasive vitrectomy technique has certain clinical application prospect.