23G玻璃体切割术后视力及眼内压影响因素的多元线性回归分析

Multiple linear regression analysis on visual acuity and intraocular pressure after 23-gauge transconjunctival sutureless vitrectomy

目的:通过研究接受23G经结膜无缝合玻璃体切割手术(23-gauge transconjunctival sutureless vitrectomy,TSV23G)患者,评价是否联合白内障超声乳化人工晶状体植入术、不同玻璃体腔填充物、术后恢复时间(术后1d;1,3mo)等因素对视力和眼内压的影响,为临床选择手术方式及评价疗效提供参考。方法:应用多元相关和回归分析56例57眼视力及眼压的临床资料。结果:视力与联合术式、术后1,3mo呈正相关,与非联合术式、术后1d、填充物的使用呈负相关。其中气体填充物、硅油填充物、术后1,3mo与视力的相关系数具有统计学意义(P=0.0005,0.0006,0.0461,0.0210)。眼内压与联合手术、术后1d;1mo、气体填充物呈正相关,与视力、未联合手术方式、术后3mo、硅油填充物呈负相关。其中,视力、手术方式、术后3mo与眼内压的相关系数有统计学意义(P=0.0038,0.0023,<0.01)。结论:行TSV23G后部玻璃体切割术联合白内障超声乳化人工晶状体植入术有利于患者的视力提高。惰性气体对于眼内压影响明显。术后视力随时间好转,眼内压早期升高,术后3mo降低。就本研究而言,术后3mo是评价手术后疗效的适宜时间。

AIM：To investigate the possible correlation of the clinical parameters including two surgical techniques（combined phacoemusification and IOL implantation and noncombined surgery）,different kinds of tamponade（infusion fluid,gas,silicone oil） and different follow-up time with the intraocular pressure（IOP） and visval acuity（VA）,and provide a reference for clinical selection of surgical approach and evaluation of efficacy.METHODS：The prospective consecutive non-comparative interventional case series study included 56 patients（57 eyes） who accepted 23-gauge transconjunctival sutureless vitrectomy（TSV23G） combined with cataract surgery or not.Clinical evaluations were performed preoperatively,postoperatively at 1 day,1 month and 3 months.Multiple linear regression were used to analysis VA and IOP.RESULTS：VA was negatively correlated with gas and silicon oil tamponaded,but positively correlated with postoperative 1 month and 3 months（P=0.0005,0.0006,0.0461,0.0210）.IOP was positively assoicated with combined surgery and gas tamponade,while negatively with postoperative 3 months（P=0.0038,0.0023,0.01）.CONCLUSION：Although combined surgery may elevate IOP,VA outcome is an inspiration to both doctor and patient.VA of gas or silicon oil tamponaded eyes are usually not good,IOP of the gas tamponaded eyes tend to elevate at early stage postoperatively.Considering to recovering time,VA elevate by time and IOP elevate at early stage postoperatively and decline since the postoperative 3 months.3 months after surgery is the appropriate time to evaluate postoperative efficacy.