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23G 经结膜无缝线玻璃体切除术联合白内障手术治疗合并白内障及后段疾病的病例

Combined 23-gauge transconjunctival sutureless vitrectomy and cataract surgery in cases with cataract and posterior segment diseases.

作者信息

Yazici Ahmet Taylan, Kara Necip, Bozkurt Ercument, Cakir Mehmet, Goker Hasan, Demirok Ahmet, Yilmaz Omer Faruk

机构信息

Istanbul Beyoglu Eye Research and Training Hospital, Galata, Istanbul, Turkey.

出版信息

Middle East Afr J Ophthalmol. 2010 Oct;17(4):359-64. doi: 10.4103/0974-9233.71602.

Abstract

BACKGROUND

Combined cataract surgery and transconjunctival sutureless vitrectomy are a good option in patients with cataract and vitreoretinal diseases.

AIM

To evaluate the effectiveness, outcomes, and complications of combined 23-gauge transconjunctival sutureless vitrectomy and cataract surgery.

SETTINGS AND DESIGN

A retrospective case series was conducted at the Beyoglu Eye Education and Research Hospital.

MATERIALS AND METHODS

In this study, 28 eyes of 28 patients underwent combined 23-gauge transconjunctival sutureless vitrectomy and phacoemulsification and IOL implantation for cataract and various posterior segment diseases. The outcome measures included, visual acuity, intraocular pressure changes, and anatomical success were evaluated.

RESULTS

The mean follow-up was 4.8 months (range, 3-15 months). Mean overall preoperative visual acuity was 20/333, and final acuity was 20/95 (P < 0.001). Mean intraocular pressure (IOP) on the preoperative and first postoperative day was 15.6 ± 7.5 and 13.8 ± 3.3 mmHg, respectively (P > 0.05). Three eyes (10.7%) had postoperative hypotony (<6 mmHg)that all recovered spontaneously within the first postoperative week. Three eyes (10.7%) required laser treatment for iatrogenic retinal tears. Anatomical success was obtained in all cases. No serious complications such as endophthalmitis were observed during the follow-up period.

CONCLUSION

Combined transconjunctival sutureless vitrectomy and phacoemulsification was effective and safe in patients with significant lens opacities and vitreoretinal pathology. Although the anatomic and visual outcomes were satisfactory, the outcomes depended mainly on underlying vitreoretinal pathology.

摘要

背景

白内障手术联合经结膜无缝线玻璃体切除术是患有白内障和玻璃体视网膜疾病患者的一个良好选择。

目的

评估23G经结膜无缝线玻璃体切除术联合白内障手术的有效性、手术效果及并发症。

设置与设计

在贝伊奥卢眼科教育与研究医院进行一项回顾性病例系列研究。

材料与方法

本研究中,28例患者的28只眼接受了23G经结膜无缝线玻璃体切除术联合白内障超声乳化吸除及人工晶状体植入术,治疗白内障及各种后段疾病。评估的结果指标包括视力、眼压变化及解剖学成功率。

结果

平均随访时间为4.8个月(范围3 - 15个月)。术前平均总体视力为20/333,最终视力为20/95(P < 0.001)。术前及术后第一天的平均眼压分别为15.6±7.5和13.8±3.3 mmHg(P > 0.05)。3只眼(10.7%)术后出现低眼压(<6 mmHg),均在术后第一周内自行恢复。3只眼(10.7%)因医源性视网膜裂孔需要激光治疗。所有病例均获得解剖学成功。随访期间未观察到诸如眼内炎等严重并发症。

结论

经结膜无缝线玻璃体切除术联合白内障超声乳化吸除术对于有明显晶状体混浊和玻璃体视网膜病变的患者有效且安全。尽管解剖学和视觉效果令人满意,但手术效果主要取决于潜在的玻璃体视网膜病变。

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