Hikichi Taiichi, Matsumoto Naomi, Ohtsuka Hideo, Higuchi Makoto, Matsushita Takuro, Ariga Hiroko, Kosaka Shyoko, Matsushita Reiko
Ohtsuka Eye Hospital, Sapporo, Japan.
Am J Ophthalmol. 2009 Apr;147(4):639-643.e1. doi: 10.1016/j.ajo.2008.10.009. Epub 2009 Jan 18.
To compare the outcomes of transconjunctival sutureless 23-gauge vitrectomy and conventional 20-gauge vitrectomy 1 year after removal of preretinal membrane.
Retrospective, consecutive, comparative case series.
One hundred consecutive eyes with a preretinal membrane underwent either 23- and 20-gauge vitrectomy. The rate of improvement of the logarithm minimum angle of resolution visual acuity (VA) was calculated by the formula: (various postoperative values-preoperative values) x 100/ (1 year postoperative values-preoperative values).
No significant differences were found between the groups in the preoperative and postoperative VAs. The VA improvement was higher and the surgically induced corneal astigmatism was lower 1 week postoperatively in the 23-gauge group compared with the 20-gauge group (P = .006 and P = .001, respectively). The flare values in the anterior chamber measured by laser flare meter preoperatively and 1 week postoperatively did not differ between the groups. The surgical time was significantly (P = .023) shorter in the 23-gauge group than in the 20-gauge group. No apparent complications developed in either group.
Transconjunctival sutureless 23-gauge vitrectomy appears effective for preretinal membrane surgery with an acceptable safety profile. Transconjunctival sutureless 23-gauge vitrectomy may be a treatment option for preretinal membranes.
比较视网膜前膜切除术后1年经结膜无缝合23G玻璃体切除术与传统20G玻璃体切除术的效果。
回顾性、连续性、比较性病例系列研究。
100例连续的视网膜前膜患者接受了23G或20G玻璃体切除术。对数最小分辨角视力（VA）的改善率通过以下公式计算：（术后各值-术前值）×100/（术后1年值-术前值）。
两组术前和术后VA无显著差异。与20G组相比，23G组术后1周VA改善更高，手术诱导的角膜散光更低（分别为P = 0.006和P = 0.001）。术前和术后1周用激光散射仪测量的前房闪光值在两组之间无差异。23G组的手术时间明显短于20G组（P = 0.023）。两组均未出现明显并发症。
经结膜无缝合23G玻璃体切除术对视网膜前膜手术似乎有效，且安全性可接受。经结膜无缝合23G玻璃体切除术可能是治疗视网膜前膜的一种选择。
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