23GTVS对复杂性孔源性视网膜脱离患者黄斑功能与形态的影响

Effect of 23GTVS on Macular Function and Morphology in Patients with Complex Rhegmatogenous Retinal Detachment

目的:探讨23G经结膜无缝合玻璃体切割手术(23GTVS)对复杂性孔源性视网膜脱离患者黄斑功能与形态的影响。方法:104例复杂性孔源性视网膜脱离患者按治疗方式分为对照组(n=52)及治疗组(n=52),对照组予以常规治疗,实验组予以23GTVS治疗。比较两组手术效果,手术前后视力,眼压,角膜散光度及角膜曲率,黄斑功能与形态及并发症发生情况。结果:术后,治疗组有效率较对照组高92.30%vs 76.92%,差异有统计学意义(P<0.05)。术后,治疗组视力明显高于对照组(P<0.05)。对照组角膜散光度及角膜曲率均于术后上升,治疗组角膜散光度及角膜曲率无变化,组间差异有统计学意义(P<0.05),两组手术前后眼压比较无差异(P>0.05)。治疗组神经上皮层水肿及黄斑下积液率和视网膜神经上皮层厚度均低于对照组3.84%vs 15.38%、7.69%vs 23.07%、(152.45±18.11)vs(162.21±20.23)μm(P<0.05)。治疗组并发症发生率低于对照组9.62%vs 25.00%,差异有统计学意义(P<0.05)。结论:23GTVS在复杂性孔源性视网膜脱离中的应用效果好,对黄斑功能及形态的影响较小。

Objective:To investigate the effect of conjunctival sutureless vitrectomy(23GTVS)on macular function and morphology in patients with complicated rhegmatogenous retinal detachment(RD).Methods:104 patients with complex conjunctival retinal detachment according to treatment mode was divided into control group(n=52)and the treatment group(n=52),the control group conventional treatment,the experimental group treatment with 23 GTVS.Then operation result,the vision,intraocular pressure,corneal dispersion and corneal curvature before and after surgery,macular function and form,and complications occurred in both group were compared.Results:Effective rate of treatment group was significantly higher than the control group 92.30%vs 76.92%,the difference was statistically significant(P<0.05).After surgery,visual acuity in the treatment group was significantly higher than in the control group(P<0.05).The corneal astigmatism and corneal curvature of the control group increased after surgery,and the corneal astigmatism and corneal curvature of the treatment group did not change.The intraocular pressure in both group was no difference statistically significant(P<0.05).The rate of neuroedema,submacular hydrops and retinal epithelial thickness in the treatment group were lower than the control group 3.84%vs 15.38%,7.69%vs 23.07%,(152.45±18.11)vs(162.21±20.23)μm(P<0.05).The incidence of complications in the treatment group was lower than that in the control group 9.62%vs 25.00%,and the difference was statistically significant(P<0.05).Conclusion:The application of 23GTVS in complex rhegmatogenous retinal detachment is effective,and has little effect on macular function and morphology.