Yoon Young H, Kim Deok-Soo, Kim June-Gone, Hwang Jong-uk
Department of Ophthalmology Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
Ophthalmic Surg Lasers Imaging. 2006 Jan-Feb;37(1):12-9.
To evaluate the efficacy of vitreoretinal surgery using a new 25-gauge transconjunctival sutureless vitrectomy system.
Forty-one eyes of 41 consecutive patients were treated from July 2003 to October 2003. Diagnoses included diabetic vitreous hemorrhage (n = 19), diabetic tractional retinal detachment (n = 4), diabetic macular edema (n = 2), macular hole (n = 3), epiretinal membrane (n = 2), branch retinal vein occlusion (n = 3), central retinal vein occlusion (n = 1), vitreous opacity (n = 4), retinal detachment (n = 1), capsular block syndrome (n = 1), and submacular hemorrhage (n = 1). The procedure was combined with phacoemulsification in 14 eyes.
All except 3 patients were operated on under retrobulbar anesthesia only. Four cases required the superior sclerotomy to be converted to a 20-gauge procedure. The mean operation time was 33 minutes and the mean balanced salt solution used was 59 cc. The mean visual acuity improved rapidly during 3 to 4 weeks following 25-gauge transconjunctival sutureless vitrectomy from 20/275 to 20/125, and then to 20/100 during the subsequent 5 months. Transient hypotony occurred in only 1 eye. Neither wound leakage nor infection was identified.
Despite some limitations in surgical indications, 25-gauge transconjunctival sutureless vitrectomy appeared to increase the efficiency of vitrectomy and to facilitate postoperative visual recovery in various vitreoretinal diseases.
评估使用新型25G经结膜无缝线玻璃体切割系统进行玻璃体视网膜手术的疗效。
2003年7月至2003年10月，连续41例患者的41只眼接受了治疗。诊断包括糖尿病性玻璃体出血（n = 19）、糖尿病性牵拉性视网膜脱离（n = 4）、糖尿病性黄斑水肿（n = 2）、黄斑裂孔（n = 3）、视网膜前膜（n = 2）、视网膜分支静脉阻塞（n = 3）、视网膜中央静脉阻塞（n = 1）、玻璃体混浊（n = 4）、视网膜脱离（n = 1）、晶状体囊膜阻滞综合征（n = 1）和黄斑下出血（n = 1）。14只眼的手术联合了超声乳化术。
除3例患者外，其余均仅在球后麻醉下进行手术。4例患者需要将上方巩膜切口改为20G手术。平均手术时间为33分钟，平均使用平衡盐溶液59毫升。25G经结膜无缝线玻璃体切割术后3至4周，平均视力从20/275迅速提高到20/125，随后5个月内提高到20/100。仅1只眼出现短暂性低眼压。未发现伤口渗漏或感染。
尽管手术适应证存在一些局限性，但25G经结膜无缝线玻璃体切割术似乎提高了玻璃体切割术的效率，并促进了各种玻璃体视网膜疾病术后视力的恢复。
