上海交通大学学报（医学版）

›› 2012, Vol. 32 ›› Issue (2): 151-.doi: 10.3969/j.issn.1674-8115.2012.02.006

• 论著（临床研究） • 上一篇    下一篇

23-G与20-G玻璃体切割术对视网膜脱离的临床疗效分析

蔡文泉, 郑 志, 李 涛, 陈凤娥, 许 迅   

  1. 上海交通大学附属第一人民医院眼科, 上海 200080
  • 出版日期:2012-02-28 发布日期:2012-02-28
  • 通讯作者: 郑 志, 电子信箱: zzheng88@sjtu.edu.cn。
  • 作者简介:蔡文泉（1964—）, 男, 主任医师；电子信箱: kent1964cn@sina.com.cn。
  • 基金资助:

    国家重点基础研究发展计划(“九七三”计划)前期研究专项课题(2010CB535006)；上海市眼底病重点实验室课题基金（0904）；上海市眼底病重点实验室开放课题基金（07Z22911）

Outcome analysis of 23-G vitrectomy versus 20-G vitrectomy for treatment of retinal detachment

CAI Wen-quan, ZHENG Zhi, LI Tao, CHEN Feng-e, XU Xun   

  1. Department of Ophthalmology, the First People's Hospital, Shanghai Jiaotong University, Shanghai 200080, China
  • Online:2012-02-28 Published:2012-02-28
  • Supported by:

    National Key Basic Research Development Program of China, 2010CB535006；Shanghai Key Laboratory for Ocular Fundus Diseases Foundation, 0904, 07Z22911

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摘要：

目的 分析23-G与20-G玻璃体切割术对视网膜脱离的临床疗效。方法 115例视网膜脱离患者分别接受23-G微创玻璃体切割术（A组，52例52眼）和20-G玻璃体切割术（B组，63例63眼）。记录手术时间和术中并发症的发生情况，术后随访6~15个月，观察术后视网膜复位、视力（logMAR视力)及并发症的发生等情况，对相关记录指标进行统计学分析比较。结果 A组和B组的手术时间分别为（67±18）min和（70±19）min，组间比较差异无统计学意义（P>005）；术中主要并发症为医源性裂孔，A组为2眼，B组为3眼。术后末次随访结果显示：A组视网膜复位49眼（复位率942%），logMAR视力提高0.337±0.046；B组视网膜复位59眼（复位率93.7%），logMAR视力提高0.367±0.052；两组间视网膜复位率和视力提高幅度比较，差异均无统计学意义（P>0.05）。结论 23-G与20-G玻璃体切割术对视网膜脱离的临床疗效相近，23-G微创玻璃体切割术适用于各种视网膜脱离患者的治疗。

关键词: 23-G微创玻璃体切割术, 20-G玻璃体切割术, 视网膜脱离, 并发症

Abstract:

Objective To analyse the outcomes of 23-G vitrectomy and 20-G vitrectomy for the treatment of retinal detachment. Methods One hundred and fifteen patients (115 eyes) with retinal detachment were enrolled, and were treated with 23-G minimally invasive vitrectomy (group A, 52 patients, 52 eyes) or 20-G vitrectomy (group B, 63 patients, 63 eyes). The duration of operation and occurrence of complications during operation were recorded. Patients were followed up for 6 to 15 months after operation, the occurrence of retinal reattachment, visual acuity (logMAR visual acuity) and occurrence of complications were observed. The related parameters were statistically analysed and compared. Results There was no significant difference in the duration of operation between group A and group B [(67±18) min vs (70±19）min, P>0.05]. The main complication during operation was iatrogenic retinal hole, with 2 eyes in group A and 3 eyes in group B. The last follow-up revealed that there were 49 eyes with retinal reattachment in group A (reattachment rate, 94.2%), and logMAR visual acuity increased 0.337±0.046. There were 59 eyes with retinal reattachment in group B (reattachment rate, 93.7%), and logMAR visual acuity increased 0.367±0.052. There was no significant difference in retinal reattachment rate and degree of visual acuity increase between two groups (P>0.05). Conclusion 23-G vitrectomy and 20-G vitrectomy may yield similar outcome for treatment of retinal detachment, and 23-G minimally invasive vitrectomy can be applicable for treatment of various vitreoretinal diseases with retinal detachment.

Key words: 23-G minimally invasive vitrectomy, 20-G vitrectomy, retinal detachment, complication