25G+与27G+玻璃体切割手术治疗玻璃体视网膜疾病的疗效比较

Observation of the curative effect of 25G+and 27G+vitrectomy in the treatment of vitreoretinal diseases

目的:对比观察25G+与27G+微创玻璃体切割手术(MIVS)治疗玻璃体视网膜疾病的疗效分析。方法:回顾性病例对照研究,选取自2018-12/2020-01期间在我院治疗的各种玻璃体视网膜疾病的患者76例76眼,随机分为25G+组和27G+组进行玻璃体切割手术治疗,对比分析两组患者的手术时间,以及术前1d,术后1d,1、4、12、24wk的ETDRS视力、眼压、结膜水肿等变化情况。结果:相对于25G+组,27G+组玻璃体切割时间较长(27.17±5.95 vs 26.71±5.93min),而总的手术时间较短(28.26±6.88 vs 30.37±6.68min),但两组间均无差异(t=0.322,P=0.748;t=-1.353,P=0.180)。两组玻璃体切割术后,视力较术前均有明显提高,但两组间比较无差异(P>0.05)。相对于25G+组,27G+组术后1d(12.58±2.44 vs 10.56±3.21mmHg,t=2.943,P=0.004)和术后1wk(13.48±2.85 vs 12.89±2.01mmHg,t=1.460,P=0.031)的眼压波动范围较低。术后1wk内,25G+组发生一过性低眼压7眼,而在27G+组无低眼压发生,表明27G+MIVS能够更好地稳定术后眼压。结论:27G+MIVS和25G+MIVS治疗玻璃体视网膜疾病安全有效。与25G+MIVS相比,27G+MIVS术后更能够很好地稳定眼压,减少因术后低眼压引起的并发症的发生。

AIM:To compare and observe the efficacy of 25G+and 27G+minimally invasive vitrectomy(MIVS)in the treatment of vitreoretinal diseases.METHODS:A retrospective case-control study,76 patients(76 eyes)with various vitreoretinal diseases treated in our hospital from December 2018 to January 2020 were selected and randomly divided into 25G+group and 27G+group underwent vitrectomy,and the operation time of the two groups of patients,as well as the changes of ETDRS visual acuity,intraocular pressure,and conjunctival edema 1d before surgery,1d after surgery,and 1,4,12,and 24wk after surgery were compared and analyzed.RESULTS:Compared with the 25G+group,the 27G+group had a longer vitrectomy time(27.17±5.95 vs 26.71±5.93min)and the total operation time was shorter than that of the 25G+group(28.26±6.88 vs 30.37±6.68 min),but there was no significant difference between the two groups(t=0.322,P=0.748;t=-1.353,P=0.180).After vitrectomy,the visual acuity of the two groups was significantly improved compared with that before operation,but there was no significant difference between the two groups(P>0.05).Compared with the 25G+group,the intraocular pressure fluctuation range of the 27G+group at 1d(12.58±2.44 vs 10.56±3.21mmHg,t=2.943,P=0.004)and 1wk(13.48±2.85 vs 12.89±2.01mmHg,t=1.460,P=0.031)after the operation was low.Within 1wk after the operation,7 eyes of transient hypotony occurred in the 25G+group,but no hypotony occurred in the 27G+group,indicating that the 27G+MIVS can better stabilize postoperative intraocular pressure.CONCLUSION:27G+MIVS and 25G+MIVS are safe and effective in the treatment of vitreoretinal diseases.Compared with 25G+MIVS,27G+MIVS can better stabilize intraocular pressure and reduce the occurrence of complications caused by postoperative hypotony.