Guyomarch J, Delyfer M-N, Korobelnik J-F
Service d'Ophtalmologie, Hôpital Pellegrin, CHU Bordeaux et Université Bordeaux 2, Bordeaux, France.
J Fr Ophtalmol. 2008 May;31(5):473-80. doi: 10.1016/s0181-5512(08)72463-x.
To evaluate the safety and efficacy of the 25-gauge transconjunctival vitrectomy system for a variety of vitreoretinal surgery indications at short-term follow-up.
Retrospective study of consecutive interventional cases that underwent surgery performed by one surgeon using the Alcon 25-Gauge vitrectomy system, in Bordeaux University Hospital, from September 2004 to May 2006. Indications were epiretinal macular membrane (72 eyes), macular hole (24 eyes), and other diseases (14 eyes).
One hundred and ten eyes of 105 consecutive patients underwent surgery. None required conversion to 20-gauge vitrectomy or wound suture. One iatrogenic retinal break occurred intraoperatively. Two transient wound leaks, seven cases of hypotonia, one of chronic endophthalmitis, one of rhegmatogenous retinal detachment, one of retinal break, two recurrent intravitreal hemorrhages, and six cases of hypertonia were noted postoperatively. Three eyes required additional surgery. Mean overall visual acuity improved from 0.691 +/- 0.465 logMAR preoperatively to 0.476 +/- 0.492 logMAR at 1 month (p<0.0001). Visual acuity improvement was statistically significant for eyes with macular epiretinal membrane (p<0.0001) and macular hole (p=0.0158). The macular hole closure rate was 87.5%. Mean operative time was 25.91+/-10.94 min. Mean follow-up was 13.32+/-18.1 weeks. Thirteen eyes developed cataracts during the follow-up period.
Vitrectomy with the 25-Gauge system appears to be relatively safe and particularly appropriate for macular surgery.
在短期随访中评估25G经结膜玻璃体切割系统用于各种玻璃体视网膜手术适应证的安全性和有效性。
对2004年9月至2006年5月在波尔多大学医院由一名外科医生使用爱尔康25G玻璃体切割系统进行手术的连续干预病例进行回顾性研究。适应证包括黄斑前膜(72只眼)、黄斑裂孔(24只眼)和其他疾病(14只眼)。
105例连续患者的110只眼接受了手术。无一例需要转换为20G玻璃体切割术或伤口缝合。术中发生1例医源性视网膜裂孔。术后发现2例短暂伤口渗漏、7例低眼压、1例慢性眼内炎、1例孔源性视网膜脱离、1例视网膜裂孔、2例复发性玻璃体积血和6例高眼压。3只眼需要额外手术。平均总体视力从术前的0.691±0.465 logMAR提高到1个月时的0.476±0.492 logMAR(p<0.0001)。黄斑前膜(p<0.0001)和黄斑裂孔(p=0.0158)患者的视力改善具有统计学意义。黄斑裂孔闭合率为87.5%。平均手术时间为25.91±10.94分钟。平均随访时间为13.32±18.1周。随访期间13只眼发生白内障。
25G系统玻璃体切割术似乎相对安全,尤其适用于黄斑手术。