25G微创眼后段玻璃体切割术的临床应用  

The application of 25G micro-invasion vitrectomy in posterior segment

作　　者：张招德[1] 宋晏平[1] 王雨晴[1] 唐涵锋[1] 李向华[1] 

机构地区：[1]福建医科大学教学医院宁德市医院眼科,福建省宁德市352100

出　　处：《中国实用眼科杂志》2013年第3期321-323,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察在局麻下行25G经结膜玻璃体切割术的疗效及适应证及时效性。方法回顾2010年10月至2012年1月53例住院患者，均为糖尿病视网膜病变玻璃体积血。其中玻璃体积血27只眼为传统的20G三通道经睫状体平坦部玻璃体切除手术；26只眼为25G经结膜玻璃体切割手术。对两组术中术后并发症、术后视力、眼部表现等进行对比分析。结果所有患者均较顺利完成手术操作；两组术后视力都有不同程度的改善，差异无统计学意义（P〉0．05）。53例患眼中，20G组术中出现医源孔3例，经局部冷凝，眼内注入隋性气体后手术顺利完成。术后20G组出现再出血1例，经保守治疗后出血吸收，术后继发性青光眼两组各3例，经局部降眼压处理后改善。未发生感染性眼内炎、驱逐性脉络膜上腔出血等严重并发症，无1例患眼再手术。结论25G经结膜玻璃体视网膜手术在轻症的糖尿病性玻璃体积血中具有可行性，手术操作简单、创伤小、并发症少、手术后恢复快等优点。ObJective To observe the effect, indications and timeliness of 25G micro-invasion transconjunctival vitrectomy under local anesthesia. Methods Reviewed 53 patients in hospital from October 2010 to January 2012. All of the patients had diabetic retinopathy vitreous hemorrhage, 27 eyes had vitrectomy for the traditional 20G three-channel ciliary body of the plain; 26 eye had vit- rectomy for 25G the conjunctival vitrectomy. Complication, postoperative visual acuity and ocular on- set presentation between two groups was comparatively analyzed and observed. Results The opera- tions finished successfully on all of the eyes, Visual acuity of two groups had a different improve- ment, the difference had no statistical significance （P 〉0.05）. In 53 sick eyes, 3 eyes had the iatro- genic retinal tear during the operation in 20G group, the operation successfully completed by local condensing and intraocular injection of inert gas. One eye bleed again after the operation in 20G group, the blood had absorpted with conservative treatment. Three cases had glaucoma after opera- tion in each group, the symptoms improved by local condensing. All the eyes had not occurred the serious complication of infectious endophthalmitis and suprachoroidal expulsive hemorrhage. All the patients had no operate again. Conclusions Diabetic retinopathy vitreous hemorrhage treated by vitreoretinal surgery using the 25G transconjunctival sutureless vitrectomy system has many advantages such as simple procedure, short operation time, micro-invasion, less complications and rapid recovery.

关 键 词：25G微切口玻璃体切割术 糖尿病视网膜病变 玻璃体积血 

分 类 号：R779.6[医药卫生—眼科]