20G与23G玻璃体切割手术治疗后段眼内异物的临床评价

发布时间：2018-07-28 08:29

【摘要】：【目的】分析20G与23G玻璃体切割手术治疗后段眼内异物的临床疗效,探讨两者有效性及安全性差异。【方法】回顾性病例研究。选取接受不同玻璃体切割手术治疗的后段眼内异物71例71只眼,根据术式不同分为20G玻璃体切割手术组(20G组)及23G玻璃体切割手术组(23G组),前者37例37只眼,后者34例34只眼。对象均予创口缝合,合并外伤性白内障者联合白内障手术,行20G/23G玻璃体切割联合球内异物取出,术中酌情行视网膜激光光凝、冷凝及眼内填充治疗。记录异物取出及视网膜复位情况、手术时间、术后炎症反应及眼部刺激症状、住院时间、最佳矫正视力以及术后并发症等情况,随访至少6个月。【结果】两组眼内异物取出率及初期视网膜复位率均100%;除术后低眼压发生率两组比较差异有统计学意义(P0.05)外,其余并发症比较差异均无统计学意义(P0.05)。两组的手术时间、平均住院日、术后炎症反应评分与眼部刺激症状以及两组手术前后的视力分布进行自身比较,差异有统计学意义(P0.05)。至末次随访,两组各自接受的非计划再次手术例数、视网膜复位情况以及术后视力分布情况比较,差异均无统计学意义(P0.05)。【结论】20G与23G玻璃体切割手术治疗后段眼内异物均安全有效,两者临床疗效及手术安全性相当;23G组术后低眼压发生率更高,但在缩短手术时间及住院时间、减轻术后炎症反应及眼部刺激症状方面较20G组更有优势。
[Abstract]:[objective] to analyze the efficacy and safety of 20 G and 23 G vitrectomy for posterior intraocular foreign bodies. [methods] retrospective study. 71 cases (71 eyes) of posterior intraocular foreign bodies treated with different vitrectomy were divided into 20G vitrectomy group (20G group) and 23G vitrectomy group (23G group). There were 37 eyes in 37 cases and 34 eyes in 34 cases in the latter group. All patients were treated with wound suture, traumatic cataract combined with cataract surgery, 20G/23G vitrectomy and extraction of intraocular foreign bodies. Retinal laser photocoagulation, condensation and intraocular filling were performed as appropriate. Foreign body removal and retinal reattachment, operation time, postoperative inflammatory reaction and ocular irritation symptoms, hospital stay, best corrected visual acuity and postoperative complications were recorded. [results] the removal rate of intraocular foreign bodies and the initial retinal reattachment rate were 100 in both groups, except the incidence of low intraocular pressure in the two groups (P0.05), but there was no significant difference in other complications (P0.05). The operation time, average hospital stay, postoperative inflammatory response score, ocular irritation symptoms and visual acuity distribution before and after operation were compared between the two groups. The difference was statistically significant (P0.05). To the last follow-up, the number of unplanned reoperation cases, retinal reattachment and visual acuity distribution were compared between the two groups. [conclusion] both 20G and 23G vitrectomy are safe and effective in the treatment of posterior intraocular foreign bodies. The clinical efficacy and safety of the two groups are similar to those of the 23G group, and the incidence of low intraocular pressure is higher in the 23G group. But it has more advantages than 20G group in shortening operation time and hospitalization time, reducing postoperative inflammatory reaction and ocular irritation symptoms.
【作者单位】：温州医科大学附属台州医院眼科;温州医科大学附属第二医院眼科;
【分类号】：R779.6

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