23G微创玻璃体切割术治疗特发性黄斑裂孔的疗效

Clinical study of 23G transconjunctival sutureless vitrectomy for idiopathic macular hole

目的:探讨23G微创玻璃体切割术(23G TSV)治疗复杂黄斑裂孔的临床效果。方法:收集我院2013-01/2015-06期间眼科收治的80例80眼黄斑裂孔患者为研究对象,采用随机平行对照法将其分为对照组和观察组各40例。对照组采用20G玻璃体手术治疗,观察组采用23G结膜无缝合玻璃体手术治疗。比较两组手术时间、住院时间、治疗前后视力变化、黄斑裂孔闭合及黄斑厚度、并发症等情况。结果:观察组患者手术时间及住院时间显著短于对照组,且术后并发症发生率显著低于对照组,差异具有统计学意义(P<0.05)。两组患者术后3、6、12mo矫正视力较术前均有显著提高,组内比较差异具有统计学意义(P<0.05),但是组间比较差异无统计学意义(P>0.05)。观察组黄斑裂孔闭合率为98%(39/40),对照组黄斑裂孔闭合率为95%(38/40),差异无统计学意义(χ~2=0.346,P=0.553)。两组患者术后3、6、12mo黄斑厚度较术前均有明显下降,组内比较差异具有统计学意义(P<0.05),但是组间比较差异无统计学意义(P>0.05)。结论:23G TSV治疗特发性黄斑裂孔具有效果显著,并发症率低,有利于促进术后视力恢复和改善预后。

·AIM： To investigate the clinical effect of 23G transconjunctival sutureless vitrectomy（23G TSV） in the treatment of idiopathic macular hole. ·METHODS：Totally 80 cases with macular hole treated in ophthalmology department of our hospital from January 2013 to June 2015 were selected as the research objects, in which 40 cases were treated with 23G TSV after admission, the other 40 cases were treated with 20G vitrectomy. The surgery time, length of hospital stay, changes of visual acuity, macular hole closure, macular thickness and complications were observed in two groups. ·RESULTS： The surgery time, length of hospital stay and the complication rate of observation group were less than those of control group with significant difference （P〈0. 05）. The corrected visual acuity was significantly improved in both groups at 3, 6, 12mo after operations compared to before operations, but no significant difference were found between the two groups （P〉0. 05）. Macular hole closure rate of observation group was 98% （ 39/40 ） , that of control group was 95% （ 38/40 ） , there was no significant difference between the two groups （χ^2=0. 346, P=0. 553）. The macular thickness significantly decreased in both groups at 3, 6, 12mo after operations compared to before operations, but no significant difference were found between the two groups （P〉0. 05）. ·CONCLUSION：23G TSV is effective in the treatment of idiopathic macular hole with low complication rate, which is beneficial to improve the postoperative visual acuity and improve the prognosis.