无缝线27G+轴心玻璃体切除术治疗黄斑前膜

The efficacy of sutureless 27G+ axial vitrectomy for macular epiretinal membrane

目的评价无缝线+27G轴心玻璃体切除术治疗黄斑前膜的临床效果。方法回顾性研究2017年6月至2018年3月21例(21眼)黄斑前膜行27G+轴心玻璃体切除术的临床资料;术后随访3个月,观察视力、眼压及黄斑中心区厚度(CMT)的变化。结果术后1周视力与术前相比差异无统计学意义(t=-1.26,P=0.22),术后1d和3个月视力高于术前,差异有统计学意义(t=-5.31、5.00,p=0.00、0.00);术后1d、1周和3个月的眼压与术前相比差异均无统计学意义(t=1.85、0.84、1.89,P=0.79、0.41、0.73);术后3个月CMT较术前低,差异有统计学意义(t=6.26,P=0.00);平均玻璃体切除时间为(20.86±3.15)min术后.术后1d有4.76%患者出现低眼压,47.62%患者发生角膜水肿;1例在术后1周时发生玻璃体积血;1例在术后1个月发生丝状角膜炎。无其他并发症发生.结论无缝线+27G轴心玻璃体切除术治疗黄斑前膜效果良好。

Objective To evaluate the clinical efficacy of sutureless 27G + axial vitrectomy for the treatment of macular epiretinal membrane. Methods Retrospective study. Twenty-one eyes of 21 patients with macular epiretinal membrane from Jun. 2017 to Mar. 2018 underwent 27G + axial vitrectomy. The follow-up time was 3 months after surgery. The changes of visual acuity, intraocular pressure, central macular thickness ( CMT) were observed. Results The difference of visual acuity was not statistically significant between before and 1 week after surgery (t =-1.26 , P = 0. 22 ). The difference of visual acuity were statistically significant between before and 1 day ,3 months after operation(t =-5. 31、5. 00, P = 0. 00、 0. 00). The difference of IOP was not statistically significant between before and 1 day, 1 week, 3 months after operation (t = 1.85、0. 84、1. 89, P = 0. 79、0. 41、0. 73 ). The difference of CMT was statistically significant between before and 3 months after operation(t =6. 26 =0. 00). The average time of vitrectomy is (20. 86 ± 3. 15 ) min. Low intraocular pressure at 1 day after operation accounted for 4. 76%;corneal edema accounted for 47. 62%;vitreous hemorrhage at 1 week after surgery in 1 patient;filamentary keratitis at 1 month postoperatively in 1 patient. No other complication occurred. Conclusion Sutureless 27G + axial vitrectomy for treatment of macular epiretinal membrane is effective.