活结缝合切口在超高度近视患者23G玻璃体切除术中的应用  

Application of removable slipknot in suturing the incision of 23-gauge vitrectomy for extremely-high myopia

作　　者：吴志勇 高菲 姚宜 陈志义 张文青 邓德勇 韩丽荣 Wu Zhiyong;Gao Fei;Yao Yi;Chen Zhiyi;Zhang Wenqing;Deng Deyong;Han Lirong(Huaxia Eye Hospital Group,Shanghai Heping Eye Hospital,Shanghai 200437,China)

机构地区：[1]华厦眼科医院集团上海和平眼科医院,上海200437

出　　处：《中华眼外伤职业眼病杂志》2023年第1期17-21,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨超高度近视患者应用聚糖乳酸缝线活结缝合23G玻璃体切除术三通道切口的临床效果。方法前瞻性队列研究。纳入2021年9月至2022年3月在上海和平眼科医院首次接受23G玻璃体切除手术的超高度近视者85例(90只眼)。按随机数字表法分为两组:活结缝合组43例(45只眼),术毕采用聚糖乳酸缝线活结缝合巩膜切口;免缝合组42例(45只眼),术毕巩膜切口自闭免缝合。术后1 d,采取眼表疾病指数量表(OSDI)进行眼表评分,并进行眼压测量。活结缝合组于术后1~2 d完成拆线,比较拆线前后眼压和并发症。结果活结缝合组术后(拆线前)眼压(11.83±2.20)mmHg,拆线后眼压(11.73±1.89)mmHg(1 mmHg=0.133 kPa)。术后与拆线后眼压比较,差异无统计学意义(t=0.25,P=0.804)。免缝合组术后眼压(8.13±1.25)mmHg。活结缝合组术后眼压明显高于免缝合组术后眼压,差异有统计学意义(t=7.75,P<0.001)。活结缝合组与免缝合组的眼表评分比较差异无统计学意义(P>0.05)。拆线后未发生低眼压、脉络膜脱离等严重并发症。结论超高度近视患者应用可拆除缝线活结缝合23G玻璃体切除手术切口,无严重并发症,患者无明显不适感且拆线后眼压稳定。Objective To evaluate the clinical efficacy of removable polylactic acid medical suture slipknot in suturing the incision of 23-gauge vitrectomy for extremely-high myopia patients.Methods This was a prospective cohort study.All extremely-high myopia patients who underwent 23-gauge vitrectomy were divided into two groups by random number table methods:45 eyes of 43 patients in the slipknot suture group with the incision sutured by removable polylactic acid medical suture slipknot after vitrectomy;45 eyes of 42 patients in the sutureless group with the incision self-closing after vitrectomy.The eye surface disease index scale(OSDI)was used for eye surface scoring,then intraocular pressure and complication were measured 1d after operation.The sutures were removed in 1-2 days after the operation in the slipknot suture group.The intraocular pressure before and after suture removal were compared.Results The postoperative intraocular pressure(before suture removal)of the slipknot suture group was(11.83±2.20)mmHg,while the intraocular pressure after suture removal was(11.73±1.89)mmHg(1 mmHg=0.133 kPa).There were no significant difference of intraocular pressure before and after suture removal in the slipknot suture group(t=0.25,P=0.804).The postoperative intraocular pressure of the sutureless group was(8.13±1.25)mmHg.The intraocular pressure after suture removal in the slipknot suture group was significantly higher than the postoperative intraocular pressure in the sutureless group,and the difference was statistically significant(t=7.75,P<0.001).There were no significant difference on surface scoring between the slipknot suture group and the sutureless group.No serious complication such as hypotony choroidal detachment occurred after suture removal.Conclusion Application of removable slipknot in suturing the incision of 23G vitrectomy for extremely-high myopia is safe without serious complications and obvious discomfort.And the IOP is stable after suture removal.

关 键 词：玻璃体切除术 近视 巩膜 眼压 

分 类 号：R779.6[医药卫生—眼科]