不同玻璃体切除手术治疗PRD的近远期疗效对比  

A comparative study of clinical efficacy of different types of vitrectomy to treat PRD

作　　者：路璐[1] 安刚[1] 许苑[2] 

机构地区：[1]辽宁省锦州市中心医院亚东眼科,121000 [2]辽宁省锦州市中心医院骨科,121000

出　　处：《临床眼科杂志》2015年第5期395-397,共3页Journal of Clinical Ophthalmology

摘　　要：目的探讨常规20G玻璃体切除术与23G玻璃体切除术对增生性糖尿病视网膜病变(PDR)患者近远期临床疗效的影响。方法 2014年1月至2014年12月选取68例PDR患者为研究对象,根据患者手术方式分为20G玻璃体手术组(20G组)36例(42只眼)及23G微创玻璃体手术组(23G组)32例(36只眼),对比分析两组患者手术情况、预后情况及并发症发生情况。结果两组患者均顺利完成手术,均一次性建立手术切口。其中23G组患者术后7、14 d最佳矫正视力均高于20G组,差异有统计学意义(P<0.05)。23G组患者术后1、7 d及1个月眼压均低于20G组(P<0.05)。两组术后7、14 d垂直及水平径向角膜曲率较术前均得到有效变化(P<0.05)。23G组术后7、14 d垂直及水平径向角膜曲率变化大于20G组(P<0.05)。23G组术后充血性水肿、角膜水肿、前房闪辉程度、前房炎症细胞发生率较20G组低,差异有统计学意义(P<0.05)。结论与常规20G玻璃体手术相比,23G玻璃体手术治疗PRD具有切口小、操时间短、对角膜曲率影响小、术后患者炎症反应轻。Objective To investigate the clinical short term and long term efficacy of conventional 20 G vitrectomy versus 23 G vitrectomy for the treatment of proliferative diabetic retinopathy（ PDR）. Methods Totally 68 cases（ 78 eyes）were divided into two vitrectomy groups. Group A（ n = 36） received 20 G vitrectomy and group B received（ n = 32） 23 G minimally invasive vitrectomy. All patients were treated between January 2014 and December 2014. Prognosis and occurrence of complications were compared between the two groups. Results All patients were successfully operated. Incisions were established in one time regardless the gauge size. The best corrected visual acuity at 7d and 14 d were higher in 23 G group than in 20 G group（ P〈0. 05）. Intraocular pressure was lower in 23 G group at 1d and 7d than in 20 G group（ P〈0. 05）. Vertical and horizontal corneal curvature was different after surgery in both groups（ P〈0. 05）,and the changes was greater in 23 G group（ P〈0. 05）. Corneal congestion,corneal edema,and anterior chamber flare,inflammatory cell counts in the anterior chamber were all milder in 23 G group than in 20 G group（ P〈0. 05）. Conclusion Compared with conventional 20 G vitrectomy,23 G vitrectomy requires a smaller incision and shorter operation time,and results in less change in corneal curvature and milder inflammatory effects.

关 键 词：常规20G玻璃体切除术 23G玻璃体切除术 增生性糖尿病视网膜病变 

分 类 号：R779.6[医药卫生—眼科]