23G 玻璃体切除术后巩膜切口处的亚临床性脉络膜脱离：前节光学相干断层扫描分析。
Subclinical choroidal detachment at sclerotomy sites after 23-gauge vitrectomy: analysis by anterior segment optical coherence tomography.
机构信息
Department of Ophthalmology, University of Würzburg, Würzburg, Germany.
出版信息
Ophthalmologica. 2010;224(5):301-7. doi: 10.1159/000298750. Epub 2010 Mar 23.
PURPOSE
Transient ocular hypotony commonly occurs after 23-gauge (23G) vitrectomy. To assess possible causes, we visualized the sclerotomy site and pars plana by anterior segment optical coherence tomography (AS-OCT).
PROCEDURES
We prospectively analyzed the intraocular pressure (IOP) and findings related to clinical hypotony, assessed by AS-OCT, in 13 consecutive eyes of 13 patients receiving 23G vitrectomy. Five patients receiving a 20G vitrectomy served as controls.
RESULTS
The mean IOP after 23G vitrectomy was 11 mm Hg (range: 5-32 mm Hg; 13 eyes) at postoperative day 1. In contrast to controls, AS-OCT showed a scleral gap at the incision site in 22/39 sclerotomies (10/13 eyes), and subclinical choroidal detachment in 9/13 eyes.
CONCLUSIONS
A scleral gap and choroidal detachment at the incision site are frequent findings following 23G vitrectomy. These subclinical features may account for postoperative hypotony as they are absent in 20G vitrectomy and scleral sutures. Hypotony following 23G vitrectomy is a self-limiting phenomenon and usually does not require therapeutic intervention.
目的
23G 玻璃体切割术后常发生一过性眼球压低。为评估可能的原因，我们通过眼前节光学相干断层扫描（AS-OCT）观察巩膜切口和扁平部。
方法
我们前瞻性分析了 13 例连续患者 13 只眼接受 23G 玻璃体切割术后的眼内压（IOP）和与临床低眼压相关的发现，其中 5 例接受 20G 玻璃体切割术的患者作为对照。
结果
23G 玻璃体切割术后第 1 天，平均 IOP 为 11mmHg（范围：5-32mmHg；13 只眼）。与对照组相比，AS-OCT 在 22/39 个巩膜切口（13 只眼中的 10 个）处显示巩膜间隙，9/13 只眼出现亚临床脉络膜脱离。
结论
23G 玻璃体切割术后，切口处巩膜间隙和脉络膜脱离是常见的发现。这些亚临床特征在 20G 玻璃体切割术和巩膜缝线中不存在，可能是术后低眼压的原因。23G 玻璃体切割术后低眼压是一种自限性现象，通常不需要治疗干预。
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