23G与20G玻璃体切割手术对晶状体损伤的观察

Damage of 23-Gauge and 20-Gauge vitrectomy system to lens

目的:观察23G与20G玻璃体切割手术系统对晶状体损伤的情况。方法:对2009-08/2010-07在我院行20G或23G有晶状体眼玻璃体切割手术患者共91例95眼进行分析。A组46例48眼行20G玻璃体切割手术,B组45例47眼行23G玻璃体切割手术,采用吊顶灯技术。术中根据病情需要进行剥膜、视网膜切开、视网膜脱离复位、异物取出、视网膜激光光凝、气液交换、玻璃体腔气体/硅油填充等步骤,对术中晶状体损伤情况进行观察。结果:20G玻璃体切割手术组18例18眼发生晶状体混浊,23G玻璃体切割手术组5例5眼发生晶状体混浊。两组均未见切割头咬伤晶状体。结论:23G手术与20G手术相比,因可以在术中灵活更换灌注套管位置,减少因器械伸入行程过长、进行对侧基底部玻璃体切割时造成的晶状体损伤。

AIM：To observe the damage of 23-Gauge and 20-Gauge vitrectomy system to lens.METHODS：Between August 2009 and July 2010,95 eyes of 91 patients suffered vitrectomy surgery.All paients were phakic.Group A contained 48 eyes of 46 patients who underwent 20-Gauge vitrectomy system.Group B contained 47 eyes of 45 patients who underwent 23-Gauge vitrectomy system.Ceiling lamp was used in 23-Gauge vitrectomy system.Epiretinal membranes peeled,retinotomy,retinal detachment attached,foreign bodies removed,retinal laser photocoagulation,air-fluid exchange,gas or/and silicone oil tamponaded and other steps were taken as needed.Whether the lenses would be damaged in the surgery was observed.RESULTS：In 20G vitrectomy group,18 eyes had lens damaged while in 23G vitrectomy group,5 eyes had lenses damaged,P0.01.CONCLUSION：23-Gauge vitrectomy system can change the tube position flexibly if necessary,reducing the damage caused by the devices during the opposite base vitreous body vitrectomy.