传统20G与微创23G玻璃体切除手术治疗玻璃体视网膜疾病疗效比较

Comparison of 20-gauge conventional vitrectomy and 23-gauge sutureless microincision vitrectomy surgery in the treatment of vitreous retinal diseases

目的比较传统20G与微创23G玻璃体切除术式对玻璃体视网膜疾病患者视力情况的改善作用。方法选取2015年7月至2016年8月榆林市第一医院收治的玻璃体视网膜病变患者82例。根据随机数字表法分为观察组及对照组各41例。对照组患者行传统20G玻璃体手术治疗,观察组患者则行微创23G玻璃体手术治疗。分别比较两组患者术前术后的眼压、视力变化情况,手术时间以及术后并发症发生情况。结果治疗后1 d、3 d、7 d观察组眼压分别为(10.7±4.2)mmHg、(11.4±4.7)mmHg、(11.7±4.8)mmHg,均显著低于对照组的(19.2±7.3)mmHg、(15.6±5.4)mmHg、(14.9±5.5)mmHg,差异均有统计学意义(均P<0.05)。治疗后观察组视力上升率为53.66%(22/41),明显高于对照组的29.27%(12/41),而视力下降率为4.88%(2/41),显著低于对照组的19.51%(8/41),差异均有统计学意义(均P<0.05)。观察组手术时间为(37.3±7.5)min,显著低于对照组的(48.3±8.0)min,差异有统计学意义(P<0.05)。术后观察组低眼压发生率为14.63%(6/41),显著高于对照组的2.44%(1/41),差异有统计学意义(P<0.05)。结论微创23G玻璃体切除术式治疗玻璃体视网膜疾病可有效改善患者视力,降低了术后眼压上升的风险,但术后早期低眼压是该治疗术式的主要并发症,应给予重视。

Objective To compare the improvement of 20-gauge conventional vitrectomy and 23-gauge sutureless microincision vitrectomy surgery in the treatment of vitreous retinal diseases. Methods A to tal of 82 cases of vitreous retinopathy patients, who admitted to our hospital from July 2015 to August 2016, were selected and divided into the observation group and the control group according to rand om number table method, with 41 cases in each group.The control group was treated with 20-gauge conventional vitrectomy surgery, and the observation group was treated with 23-gauge sutureless microincision vitrectomy surgery. The changes of intraocular pressure, visual acuity, operation time and postoperative complications were compared between the two groups before and after the surgery. Results The levels of intraocular pressure at 1 day, 3 days and 7 days after treatment in the observation group were（10.7±4.2） mmHg,（11.4 ± 4.7） mmHg,（11.7 ± 4.8） mmHg, respectively, which were significantly lower than（19.2 ± 7.3） mmHg,（15.6 ± 5.4）mmHg,（14.9±5.5） mmHg in the control group（all P〈0.05）. After the treatment, the vision rising rate of the observation group was 53.66% （22/41）, which was significantly higher than 29.27% （12/41） of the control group; the vision loss rate of the observation was 4.88% （2/41）, which was significantly lower than 19.51% （8/41） of the control group（P〈0.05）.The operation time of the observation group was （37.3±7.5） min, which was significantly shorter than（48.3±8.0） min of the control group（P〈0.05）. The incidence of postoperative low intraocular pressure in the observation group was 14.63% （6/41）, which was significantly higher than 2.44% （1/41） in the control group（P〈0.05）. Conclusion 23-gauge sutureless microincision vitrectomy surgery can effectively improve the patients＇ vision in the treatment of vitreous retinal diseases and reduce the risk of postoperative intraocular pressure rise, but low early postoperative intraocular pressure is the main complications of the treatment procedure, which should be paid attention to .