山东大学耳鼻喉眼学报 ›› 2017, Vol. 31 ›› Issue (5): 92-94.doi: 10.6040/j.issn.1673-3770.0.2017.024

• 论著 • 上一篇    下一篇

25+微创玻璃体视网膜手术治疗孔源性视网膜脱离的临床观察

周学义,李一鸣,王美菊,张苑苑,张历浊   

  1. 秦皇岛视光眼科医院, 河北 秦皇岛 066000
  • 收稿日期:2017-01-13 出版日期:2017-10-16 发布日期:2017-10-16
  • 通讯作者: 周学义. E-mail:zxy790829@163.com
  • 基金资助:
    秦皇岛市科学技术研究与发展计划(201502A083)

Clinical observation of 25-gauge minimally invasive vitreous retinal surgery for treatment of rhegmatogenous retinal detachment.

ZHOU Xueyi, LI Yiming, WANG Meiju, ZHANG Yuanyuan, ZHANG Lizhuo   

  1. Qinhuangdao Shiguang Eye Hospital, Qinhuangdao 066000, Hebei, China
  • Received:2017-01-13 Online:2017-10-16 Published:2017-10-16

摘要: 目的 研究25+微创玻璃体视网膜手术治疗孔源性视网膜脱离的临床效果。 方法 回顾性分析孔源性视网膜脱离患者52例(52眼),治疗组(n=26)行25+微创玻璃体视网膜手术,对照组(n=26)行23G微创玻璃体视网膜手术。分析两组患者手术时间、术后视力、眼压、并发症和视网膜复位情况。 结果 与对照组比较,治疗组手术时间缩短(P<0.05);术后3 d及术后7 d,两组患者眼压较术前均升高,最佳矫正视力的最小分辨角对数均降低(P<0.05);术中治疗组并发症发生率(15.38%)低于对照组(42.31%)(P<0.05);术后治疗组低眼压发生率(3.85%)低于对照组(30.77%)(P<0.05);治疗组视网膜复位率(92.31%)与对照组(88.46%)比较差异无统计学意义(P>0.05)。 结论 25+与23G微创玻璃体视网膜手术治疗孔源性视网膜脱离的临床效果相当,但25+微创玻璃体视网膜手术能有效减少术中并发症及术后低眼压的发生,具有更高的安全性。

关键词: 玻璃体视网膜手术, 25+, 疗效, 23G, 低眼压, 孔源性视网膜脱离

Abstract: Objective To investigate the clinical effect of 25-gauge minimally invasive vitrectomy for treatment of rhegmatogenous retinal detachment. Methods This was a retrospective analysis of 52 patients with retinal detachment treated in our hospital. Patients were divided into treatment and control groups(n=26 each). The treatment group was treated with 25+ minimally invasive vitrectomy, and the control group was treated with 23G minimally invasive vitrectomy. The two groups were followed up for at least 3 months. The following parameters were evaluated: duration of the procedure, postoperative visual acuity, intraocular pressure, complications, and retinal restoration. Results The duration of the procedure in the treatment group was significantly shorter than that in the control group(P<0.05). Three and seven days following the operation, the intraocular pressure in both groups increased significantly. The postoperative logarithm of the minimum angle of resolution(LogMAR)visual acuity was significantly lower than the preoperative value(P<0.05). The incidence rate of complications in the treatment group was 15.38%, which was significantly lower than that in the control group(42.31%; P<0.05). The incidence rate of intraocular hypotension in the treatment group(3.85%)was significantly lower than that in the control group(30.77%)(P<0.05). There were no statistically significant differences in the retinal replacement rates between the treatment and control groups(92.31% and 88.46%, respectively; P>0.05). Conclusion Both 25-gauge and 23G minimally invasive vitrectomy have similar effectiveness in the treatment of rhegmatogenous retinal detachment, but the former is safer and is associated with a lower risk of postoperative complications and intraocular hypotension.

Key words: Vitreoretinal surgery, 25+, Intraocular hypotension, Clinical effect, Ruptural detachment of retina, 23G

中图分类号: 

  • R779.6
[1] 林美英, 朱小华, 周亮, 等. 孔源性视网膜脱离的治疗进展[J]. 临床眼科杂志, 2016, 24(4):376-379. LIN Meiying, ZHU Xiaohua, ZHOU Liang, et al. The advances in treatment of rhegmatogenous retinal detachment[J]. J Clin Ophthalmol, 2016, 24(4):376-379.
[2] 柯治生, 宋宗明, 王瑞华. 23G/25G微创玻璃体手术联合眼内填充治疗孔源性视网膜脱离[C]. 中国眼底病论坛暨第十四次全国眼底病学术会议, 2011.
[3] 李志勇, 李云环. 改良式巩膜扣带术治疗孔源性视网膜脱离[J]. 中华眼外伤职业眼病杂志, 2015, 37(2):118-120. LI Zhiyong, LI Yunhuan. Modified scleral buckling for rhegmatogenous retinal detachment[J]. Chin J Ocul Traum Occupat Eye Dis, 2015, 37(2):118-120.
[4] Fujii GY, De Juan E, Humayun MS, et al. A new 25-gauge instrument system for transconjunctival sutureless vitrectomy surgery[J]. Ophthalmology, 2002, 109(10):1807-1813.
[5] 李云环. 孔源性视网膜脱离治疗体会[J]. 国际眼科杂志, 2013, 13(12):2449-2451. LI Yunhuan. Experience on the treatment of rhegmatogenous retinal detachment[J]. Int Eye Sci, 2013, 13(12):2449-2451.
[6] 朱萍, 邱凤霞, 王希铭, 等. 应用25G+与20G玻璃体切除术治疗视网膜脱离的比较[J]. 中华眼外伤职业眼病杂志, 2015, 37(10):757-759. ZHU Ping, QIU Fengxia, WANG Ximing, et al. The comparison between the 25G+ and 20G vitrectomy in treating rhegmatogenous retinal detachment[J]. Chin J Ocul Traum Occupat Eye Dis, 2015, 37(10):757-759.
[7] 张楠, 孙晓萍, 高延庆, 等. 23G TVS与25G TVS治疗复杂性孔源性视网膜脱离的临床疗效观察[J]. 眼科新进展, 2013, 33(1):77-79. ZHANG Nan, SUN Xiaoping, GAO Yanqing, et al. Clinical effects of 23G TVS and 25G TVS for complicated rhegmatogenous retinal detachment[J]. Rec Adv Ophthalmol, 2013, 33(1):77-79.
[8] 陆颖丽, 周用谋. 23G与25G+玻璃体切割手术治疗视网膜脱离的对比分析[J]. 国际眼科杂志, 2016, 16(6):1110-1112. LU Yingli, ZHOU Yongmou. Analysis of 23G and 25G+ vitrectomy for retinal detachment[J]. Int Eye Sci, 2016, 16(6):1110-1112.
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