方法：选取2013-11/2016-05于我院眼科行玻璃体切割术治疗的128例195眼PDR患者，随机分为两组，25G+组64例97眼，23G组64例98眼。25G+组应用25G+玻璃体切割术，23G组应用23G玻璃体切割术。两组患者术后随访时间分别为1d，1wk，1mo。比较两组手术时间，术前及术后的眼压、最佳矫正视力及医源性损伤、并发症发生情况。

结果：25G+组手术时间短于23G组(P<0.05)； 两组患者术后1mo的视力分布均显著优于本组术前的视力分布(P<0.01)； 两组同期的视力分布没有统计学差异(P>0.05)。25G+组术前的眼压分别与手术1d，1wk，1mo的眼压比较，差异均没有统计学意义(P>0.05)； 23G组亦然。两组同期的眼压比较也无统计学差异(P>0.05)。25G+组的医源性损伤率为4.1%，显著低于23G组的13.3%，差异有统计学意义(P<0.05)。25G+组的术后并发症发生率为3.1%，显著低于23G组的11.2%，差异有统计学意义(P<0.05)。

结论：23G和25G+玻璃体切割术均可安全有效地治疗PDR，但是25G+微创玻璃体切割术在缩短手术时间、减少医源性损伤及并发症发生率方面显示出更好的优势，是治疗PDR的更好选择。

METHODS: A total of 128 PDR patients(195 eyes)requiring vitrectomy in our hospital from November 2013 to May 2016 were randomly divided into 25G+ group and 23G group, 64 cases(97 eyes)in 25G+ group and 64 cases(98 eyes)in 23G group. In 25G+ group, patients were treated by 25G+ vitrectomy. In 23G group, patients were treated by 23G vitrectomy. The visual acuity, as well as intraocular pressure(IOP), iatrogenic injury and complications in two groups were recorded before and 1d, 1wk, 1mo after treatment. The operation time was compared between two groups.

RESULTS: The operation time in 25G+ group was lower than that in 23G group(P<0.05). The postoperative visual acuity at 1mo of two groups were improved compared with before surgery(P<0.01). However, visual acuity between two groups in the same period had no significant difference(P>0.05). IOP in 25G+ group before surgery had no significant difference compared with those after surgery at 1d,1wk, and 1mo(P>0.05), which it was the same in 23G group. IOP of two groups in the same period had no significant difference(P>0.05). The incidence rate of iatrogenic injury in 25G+ group was 4.1%, which was significant lower than that of 23G group(13.3%)(P<0.05). The incidence rate of complication in 25G+ group was 3.1%, which was significant lower than that of 23G group(11.2%)(P<0.05).

CONCLUSION: Both 23G and 25G+ vitrectomy are safe and effective treatment for PDR. However, 25G+ vitrectomy is the better choice for PDR for the shorter operation time, lower incidence rate of iatrogenic injury and fewer surgical complications.