Okamoto F, Okamoto C, Sakata N, Hiratsuka K, Yamane N, Hiraoka T, Kaji Y, Oshika T
Department of Ophthalmology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan.
Ophthalmology. 2007 Dec;114(12):2138-41. doi: 10.1016/j.ophtha.2007.01.034.
To evaluate the changes in regular and irregular corneal astigmatism after 25-gauge transconjunctival sutureless vitrectomy and 20-gauge standard vitrectomy.
Prospective observational comparative case series.
Thirty-two eyes of 32 patients undergoing 25-gauge transconjunctival sutureless vitrectomy and 25 eyes of 24 patients undergoing 20-gauge standard vitrectomy.
Corneal topography was obtained preoperatively and at 2 weeks and 1 month postoperatively.
The dioptric data of the central 3-mm zone of the cornea were decomposed using Fourier harmonic analysis into spherical power, regular astigmatism, asymmetry, and higher-order irregularity.
None of the 4 Fourier indices changed throughout the observation period in the 25-gauge group. In the 20-gauge group, regular astigmatism, asymmetry, and higher-order irregularity were increased significantly at 2 weeks after vitrectomy (P<0.05, Wilcoxon signed-ranks test) and returned to preoperative levels by 1 month. The spherical power in the 20-gauge group did not change after surgery. For regular astigmatism, asymmetry, and higher-order irregularity, the 20-gauge group showed significantly greater surgically induced changes than the 25-gauge group (P<0.05, Mann-Whitney U test).
Twenty-five-gauge transconjunctival sutureless vitrectomy does not induce significant changes in corneal topography and exerts little influence on the optical quality of the cornea.
评估25G经结膜无缝线玻璃体切除术和20G标准玻璃体切除术后规则和不规则角膜散光的变化。
前瞻性观察性比较病例系列。
32例行25G经结膜无缝线玻璃体切除术患者的32只眼，以及24例行20G标准玻璃体切除术患者的25只眼。
术前、术后2周和1个月进行角膜地形图检查。
使用傅里叶谐波分析将角膜中央3mm区域的屈光度数据分解为球镜度、规则散光、不对称性和高阶不规则性。
25G组在整个观察期内4个傅里叶指数均未发生变化。在20G组中，玻璃体切除术后2周时规则散光、不对称性和高阶不规则性显著增加（P<0.05，Wilcoxon符号秩检验），并在1个月时恢复到术前水平。20G组术后球镜度未发生变化。对于规则散光、不对称性和高阶不规则性，20G组手术引起的变化显著大于25G组（P<0.05，Mann-Whitney U检验）。
25G经结膜无缝线玻璃体切除术不会引起角膜地形图的显著变化，对角膜光学质量影响较小。
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