27+G微创玻璃体切除术临床运用初步报道  

Preliminary clinical application of vitrectomy surgery using 27+ gauge microincision for posterior segment disease

作　　者：刘三梅[1] 钟捷[1] 李杰[1] 李芳[1] 邓铂林[1] 周采虹 

机构地区：[1]四川省人民医院眼科,四川成都610072

出　　处：《西南医科大学学报》2017年第2期144-149,共6页Journal of Southwest Medical University

摘　　要：目的:观察27+G微创玻璃体切术用于治疗玻璃体视网膜疾病的手术效率、安全性及术后反应等,总结初步临床经验。方法:回顾性分析了我院自2015年6月至2016年3月期间所行的61例27+G微创玻璃体切除术。并将同期127例25+G玻璃体切除术病例作为对照。所有患者术前均行视力、眼压、三面镜、眼部B超及眼底检查,记录手术时间及术中并发症,术后随访6~40周,观察视力、眼压、眼前节反应及眼底等。结果:27+G组61眼,25+G组127眼。平均手术时间分别为(52.7±4.2)min(27+G组)及(59.3±2.8)min(25+G组),两组无明显差异(P=0.151)。术中27+G组无巩膜切口缝合;术后27+G组37眼(60.7%)患眼最佳矫正视力(BCVA)有所改善,而25+G组88眼(69.2%)BCVA有所改善,两组间无显著差异(P=0.24)。术后随访,27+G组术后眼部刺激症状相对25+G组轻,27+G组无一过性低眼压,一过性高眼压发生率同25+G组相比,无明显差异(P=0.215);两组均未发生感染性眼内炎及增殖性玻璃体视网膜病变等。结论:27+G微创玻璃体切除术术后反应轻,巩膜切口恢复快,未见严重手术相关并发症。27+G微创玻璃体切除术安全、实用。Objective： To evaluate the efficiency, safety profile, postoperative reaction and preliminary experience of using 27 gauge pars plana vitrectomy （PPV） in eyes with posterior segment disease.Methods： Sixty-one eyes undergone three-port, transconjunctival 27＋ gauge PPV were retrospectively analyzed and 127 cases of 25 gauge PPV in same period were set as controls. Visual acuity, intraocular pressure, operation time and occurrence of intraoperative and postoperative complications were recorded with 6 ~ 40 weeks of follow-up.Results： The average operation time was 52.7 ± 4.2 min in 27＋G group and 59.3 ± 2.8 min in 25 ＋ G group, showing no significant difference（P = 0.151）. No sclerotomy sites need suturing in 27＋ G PPV. The best correct vision acuity （BCVA） was improved in 37 eyes（60.7%） in 27＋G group versus 88（69.2%） eyes in 25 ＋ G group （P = 0.24）. Only mild postoperative reaction of anterior segment was observed in 27＋G group and no transient hypotony was observed. There is no significant difference between two group in terms of transient ocular hypertension （P = 0.215）. No postoperative endophthalmitis and proliferative vitreoretinopathy were encountered in follow-up period. Conclusions： 27＋ gauge PPV is a simple and well tolerated vitrectomy operation procedure, with low rates of intraoperative and postoperative complications and faster wound healing.

关 键 词：玻璃体切除术 微创 临床运用 增殖性玻璃体视网膜病变 最佳矫正视力 玻璃体视网膜疾病 平均手术时间 眼部刺激症状 

分 类 号：R776[医药卫生—眼科]