Hsu Jason, Chen Eric, Gupta Omesh, Fineman Mitchell S, Garg Sunir J, Regillo Carl D
Retina Service, Wills Eye Institute, Philadelphia, Pennsylvania 19107, USA.
Retina. 2008 Jul-Aug;28(7):937-40. doi: 10.1097/IAE.0b013e31816c6855.
To compare intraocular pressure (IOP) and rates of postoperative hypotony with 25-gauge pars plana vitrectomy (PPV) without tamponade using oblique versus direct cannula insertions.
A prospective consecutive series of eyes that underwent 25-gauge PPV without tamponade using an oblique cannula insertion technique was compared with a historical consecutive series of eyes that underwent 25-gauge PPV without tamponade using direct cannula insertions. IOP was recorded before surgery, on postoperative day 1, and on postoperative week 1.
Ninety-five eyes had 25-gauge PPV without tamponade, 55 with oblique cannula insertions and 40 with direct insertions. With oblique insertions, there was no statistically significant difference between mean IOPs measured before surgery, on postoperative day 1, and on postoperative week 1. Only 1 (1.8%) of the 55 eyes had hypotony (IOP, <or=5 mmHg) on postoperative day 1. With direct insertions, mean postoperative day 1 IOP was significantly lower than mean preoperative IOP (P = 0.009). Mean preoperative and postoperative week 1 IOPs were similar. Four (10%) of 40 eyes had hypotony on postoperative day 1.
Oblique cannula insertions may be superior to direct cannula insertions for lowering rates of absolute and relative postoperative day 1 hypotony in 25-gauge PPV without tamponade.
比较在不使用填塞物的25G玻璃体切割术（PPV）中，采用斜向插管与直接插管时的眼内压（IOP）及术后低眼压发生率。
将采用斜向插管技术进行不使用填塞物的25G PPV的前瞻性连续系列患眼，与采用直接插管进行不使用填塞物的25G PPV的历史连续系列患眼进行比较。记录手术前、术后第1天和术后第1周的IOP。
95只眼接受了不使用填塞物的25G PPV，其中55只采用斜向插管，40只采用直接插管。采用斜向插管时，手术前、术后第1天和术后第1周测得的平均IOP之间无统计学显著差异。55只眼中仅1只（1.8%）在术后第1天出现低眼压（IOP≤5 mmHg）。采用直接插管时，术后第1天的平均IOP显著低于术前平均IOP（P = 0.009）。术前和术后第1周的平均IOP相似。40只眼中有4只（10%）在术后第1天出现低眼压。
在不使用填塞物的25G PPV中，斜向插管在降低术后第1天绝对和相对低眼压发生率方面可能优于直接插管。
