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[摘要]
目的:评估23G经结膜无缝线玻璃体切割手术治疗孔源性视网膜脱离的安全性及有效性。 方法:前瞻性选择2010-03/2011-06共26例26眼不伴有严重增生性病变的孔源性视网膜脱离病历,均行23G切割手术。记录术前、术后的最佳矫正视力(BCVA)、眼压,术中及术后并发症。 结果:一次性复位视网膜21例(81%),最终复位视网膜25例(96%)。术后3mo最佳矫正视力较术前提高21例(80%),不变3例(12%),下降2例(8%)。术后1d眼压较术前下降,此差异有统计学意义(P<0.01)。低眼压(≤6mmHg)2例,持续2wk,但未发生脉络膜脱离。 结论:23G手术治疗孔源性视网膜脱离解剖复位率满意,术后视力改善明显。但23G微创手术的优势并没有在孔源性视网膜脱离的手术中得到充分体现,反而要面临更高的手术失败的风险。
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[Abstract]
AIM:To evaluate the safety and efficacy of 23-gauge transconjunctival sutureless pars plana vitrectomy for rhegmatogenous retinal detachment( RRD). METHODS:Totally 26 consecutive cases(26 eyes) were recruited between March 2010 and June 2011. All surgeries were performed with the 23-gauge technique. Main outcome measures included visual acuity, intraocular pressure, operative complications.Postoperative mean follow-up were 3 months. RESULTS:Anatomical success was achieved in 81% of 21 cases with single surgery and rose to 96% of 25 cases with additional surgery. Mean visual acuity improved in 21 cases (80%),unchanged in 3 cases(12%),declined in 2 cases(8%). The differences of intraocular pressure at postoperative 1 day was significant(P<0.01).Two cases with ocular hypotony (intraocular pressure ≤6mmHg), sustained for 2 weeks and did not occur choroidal detachment. CONCLUSION:Acceptable anatomical and functional success rates can be achieved with 23-gauge transconjunctival sutureless vitrectomy for RRD. The main advantages of this technique are lost in RRD surgery and had to faced higher failure rate.
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