Department of Ophthalmology, Medical University, Graz, Austria.
Retina. 2010 Jan;30(1):112-6. doi: 10.1097/IAE.0b013e3181b32ebf.
The purpose of this study was to investigate the safety profile of the 23-gauge sutureless vitrectomy system in the treatment of epiretinal membranes compared with standard 20-gauge vitrectomy.
A retrospective case comparison of 20-gauge and 23-gauge vitrectomy performed in 167 and 64 eyes, respectively, by the same surgeon. Intraoperative and postoperative complications, duration of surgery, and postoperative visual acuity results were evaluated.
Postoperative hypotony occurred significantly more often in the 23-gauge group [9.4% (n = 6) vs. 0% (n = 0), P < 0.001]. With the 23-gauge system, the incidence of retinal detachment was 1.6% (n = 1), vitreous hemorrhage was 0%, and endophthalmitis was 1.6% (n = 1). Patients with 20-gauge vitrectomy developed retinal detachments in 1.8% (n = 3), vitreous hemorrhages in 1.2% (n = 2), and endophthalmitis in 2.4% (n = 4). The mean overall duration of surgery was significantly shorter in the 23-gauge procedures with 23.1 +/- 6.5 minutes compared with 34.5 +/- 9.1 minutes in the 20-gauge procedures (P < 0.05). At postoperative Day 2, patients with 23-gauge vitrectomy regained preoperative mean best-corrected visual acuity of 20/60. Patients who had 20-gauge vitrectomy experienced a statistically significant decrease of visual acuity from 20/80 to 20/100 (P < 0.05).
Twenty-three-gauge vitrectomy in epiretinal membrane surgery is comparable with 20-gauge vitrectomy and is a safe method with a low complication rate. However, the incidence of postoperative hypotony is more frequent using the 23-gauge system.
本研究旨在比较 23 号无缝线玻璃体切割系统与标准 20 号玻璃体切割术治疗眼内膜的安全性。
由同一位外科医生对 20 号和 23 号玻璃体切割术分别进行回顾性病例比较，共涉及 167 只眼和 64 只眼。评估术中及术后并发症、手术持续时间及术后视力结果。
术后低眼压在 23 号组中更为常见[9.4%（n=6）比 0%（n=0），P<0.001]。使用 23 号系统，视网膜脱离的发生率为 1.6%（n=1），玻璃体积血为 0%，眼内炎为 1.6%（n=1）。接受 20 号玻璃体切割术的患者中，视网膜脱离发生率为 1.8%（n=3），玻璃体积血发生率为 1.2%（n=2），眼内炎发生率为 2.4%（n=4）。23 号组的手术总持续时间明显短于 20 号组，分别为 23.1±6.5 分钟和 34.5±9.1 分钟（P<0.05）。术后第 2 天，23 号玻璃体切割术患者恢复术前平均最佳矫正视力 20/60。接受 20 号玻璃体切割术的患者视力从 20/80 显著下降至 20/100（P<0.05）。
眼内膜手术中 23 号玻璃体切割术与 20 号玻璃体切割术相当，是一种安全的方法，并发症发生率低。然而，使用 23 号系统时术后低眼压的发生率更高。
