23G20G联合玻璃体切割手术治疗脉络膜脱离型视网膜脱离的临床观察

Clinical observation of Combined 20-gauge and 23-gauge pars plana vitrectomy for the treatment of retinal detachment associated with choroidal detachment

目的观察23G联合20G玻璃体切割手术治疗脉络膜脱离型视网膜脱离的临床疗效及安全性。方法将2014年1月至2015年1月于我院明确诊断脉络膜脱离型视网膜的患眼并行23G联合20G玻璃体切割手术治疗的共37例病例37只眼纳入研究。记录术前视力、眼压及眼部病情,手术中切除玻璃体后采用硅油或C3F8气体填充玻璃体腔,术后采取面向下体位。术后平均随访4.34月,观察术后视网膜复位率、术后视力、术后并发症等情况。结果至随访期结束,视网膜复位31例(83.7%);术后视力较术前提高,差异有统计学意义;发生一过性高眼压11例(29.7%),持续性高眼压2例;发生并发性白内障18例(48.6%)结论 23G联合20G玻璃体切割?术是治疗脉络膜脱离型视网膜脱离的安全有效方法。

Objetive To investigate the clinical safety and efficacy of a combination of 20-gauge（20G） and 23-gauge（23G） pars plana vitrectomy in the treatment of retinal detachment associated with choroidal detachment. Methods From January 2014 to January 2015 in our hospital, a total of 37 patients（37eyes）with retinal detachment associated with choroidal detachment,which were treated with combined 20-gauge and 23-gauge pars plana vitrectomy, were enrolled in this study. Preoperative visual acuity, intraocular pressure and other eye condition were recorded. Silicone oil or C3F8 gas were used to filled vitreous cavity after removal of the vitreous body. Postoperative patients were asked to take the face-down position. The median follow-up time was 4.34 months. Postoperative retinal reattachment rate, postoperative visual acuity and complications were recorded. Results Retinal reattachment was attained in 31 eyes（83.7%）; Postoperative visual acuity was improved, and the difference was statistically significant; There were 11 cases（29.7%） of transient ocular hypertension, 2 cases of persistent ocular hypertension, and 18 cases of complicated cataract（48.6%）. Conclusions The combination of 23 G and 20 G pars plana vitrectomy is an efficacious and safe procedure for treatment of retinal detachment associated with choroidal detachment.