Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Retina. 2010 Sep;30(8):1237-41. doi: 10.1097/IAE.0b013e3181dde612.
To evaluate the safety and efficacy of passive removal of silicone oil with 23-gauge (G) transconjunctival sutureless system.
This is a single-center, prospective, interventional, randomized control study. Forty eyes of 40 patients were enrolled in this study and randomized into 2 groups. Group 1 (n = 20) patients underwent passive removal of silicone oil with 23-G transconjunctival sutureless system. Group 2 (n = 20) underwent 20-G active silicone oil removal using all three 20-G ports. In both groups, air-fluid exchange was performed and the globe was left air filled at the end of surgery. All eyes in both groups received 360 degrees endolaser. We recorded surgical time, time for silicone oil removal, number of sutured 23-G sclerotomy sites, presence of preoperative scarring at sclerotomy site, postoperative hypotony, endophthalmitis, and inflammation at sclerotomy site.
Opening and closing times were significantly shorter in Group 1 than in Group 2. Only 3 cases (15%) in Group 1 required 1 additional suture each in the superior sclerotomy site. Both groups were similar in safety in terms of chance of endophthalmitis, redetachment rate, and postoperative hypotony. Only 1 patient of Group 1 (5%) and 5 patients of Group 2 (25%) showed significant conjunctival inflammation at the end of 2 weeks.
Passive removal of silicone oil with 23-G transconjunctival sutureless system may hasten postoperative recovery by decreasing overall surgical time and postoperative inflammation. It is a safe and effective procedure when compared with 20-G active silicone oil removal for 1000 centistoke oil.
评估 23G 经结膜无缝线系统被动去除硅油的安全性和有效性。
这是一项单中心、前瞻性、干预性、随机对照研究。本研究纳入了 40 例(40 只眼)患者,并将其随机分为 2 组。第 1 组(n=20)患者采用 23G 经结膜无缝线系统被动去除硅油。第 2 组(n=20)采用 20G 主动硅油去除术,通过三个 20G 端口进行。两组患者均行空气-液交换,手术结束时眼球内填充空气。两组患者均接受 360 度眼内激光治疗。我们记录了手术时间、硅油去除时间、缝合的 23G 巩膜切开部位数量、巩膜切开部位术前瘢痕情况、术后低眼压、眼内炎和巩膜切开部位炎症。
第 1 组的打开和关闭时间明显短于第 2 组。第 1 组仅 3 例(15%)患者需要在上方巩膜切开部位各额外缝合 1 针。两组在眼内炎、复发性视网膜脱离和术后低眼压的安全性方面相似。第 1 组仅 1 例(5%)患者和第 2 组 5 例(25%)患者在第 2 周结束时出现明显的结膜炎症。
与 20G 主动硅油去除术相比,23G 经结膜无缝线系统被动去除硅油可能通过减少总手术时间和术后炎症来加速术后恢复。对于 1000 厘沲硅油,这是一种安全有效的方法。