23G无缝线玻璃体切割手术在治疗玻璃体视网膜疾病中的应用

Application of 23-gauge transconjunctival sutureless vitrectomy system in various vitreoretinal diseases

目的：探讨23 G无缝线玻璃体切割手术治疗玻璃体视网膜疾病的疗效。方法：应用23 G无缝线玻璃体切割技术在接触式广角镜下对154例玻璃体视网膜疾病进行手术，观察手术疗效，术中及术后并发症，手术时间，手术前后视力及眼压变化。结果：1.共134例154眼均顺利完成。2.手术时间28~83 min，平均（42.0±5.2 ）min。3.术后1、2、3月最佳矫正视力与术前对比均有所提高（n=154,具体P值见表1）。4.术前与术后第1、3、7、30天眼压比较，术后第1天有较低的眼压和较高的眼压，术后3天高眼压较多，术后7天、30天眼压稳定。5.3例（1.9%）术后出现低眼压，15例（9.7%）高眼压，无眼内炎发生。结论 ：采用23 G无缝线玻璃体手术治疗玻璃体视网膜疾病, 具有手术时间短、创伤小、并发症少、术后视力恢复快、 手术疗效确切的优点。

Objective：To discuss the efficacy of vitreoretinal surgery using 23-gauge transconjunctival sutureless vitrectomy（TSV） system for various vitreoretinal diseases. Methods：A total of 154 eyes of patients who underwent vitreoretinal procedures using 23-gauge minimally invasive surgery vitrectomy system in wide field retionscope were enrolled. Efficacy,intraoperative and postoperative complications and operation time were observed. Moreover,intraocular pressure （IOP） and best corrected visual acuity （BCVA） of pre-and post-operation were determined. Results：①All operation were performed successfully. ②Mean duration of operation was （42.0 ± 5.2） min （ranging from 28 min to 83 min）. ③BCVA was improved at 1,2,3 months after operation compared with that before operation.④ Compared with those before operation, both lower and higher IOP were observed on 1 d after operation, higher IOP was observed on 3 d after operation and steady IOP was found on 7 d and 30 d after the operation. ⑤3 eyes（1.9%） had ocular hypotensipon after operation, 15 cases（9.7%） had ocular hypertension and no case of endophthalmitis was reported. Conclusion：With the advantages of shorter operation time,less trauma,fewer complications, more convenient and rapid visual recover, 23-gauge TSV system is effective in the treatment of vitreoretinal diseases.