23G 无缝合玻璃体切除术是否会改变黄斑手术后视网膜脱离的风险？与 20G 玻璃体切除术的比较。

Does 23-gauge sutureless vitrectomy modify the risk of postoperative retinal detachment after macular surgery? A comparison with 20-gauge vitrectomy.

机构信息

Vitreoretinal Department, Sourdille Clinic, Nantes, France.

出版信息

Retina. 2011 May;31(5):902-8. doi: 10.1097/IAE.0b013e3182069aa4.

DOI:10.1097/IAE.0b013e3182069aa4

PMID:21394061

Abstract

PURPOSE

To compare the cumulative risk of retinal detachment (RD) after macular surgery with 23-gauge sutureless vitrectomy and with 20-gauge vitrectomy.

METHODS

A single-center retrospective comparative study was conducted, comparing eyes operated for epiretinal membrane, macular hole, vitreomacular traction, and internal limiting membrane peeling. The 23-gauge group included 349 eyes operated consecutively between June 2007 and December 2008. The 20-gauge group included 346 eyes operated between October 2003 and September 2007.

RESULTS

After a 6-month follow-up, the cumulative probability of RD was 1.1% in the 23-gauge group and 3.5% in the 20-gauge group (P = 0.04). With a median follow-up of 14 months (range, 6-30 months) in the 23-gauge group and 30 months (range, 6-72 months) in the 20-gauge group, the cumulative probability of RD was, respectively, 1.1% and 4.9% (P = 0.04; log-rank test). Overall, RD was observed in 7 of 96 cases after macular hole surgery (7.3%), in 11 of 478 cases after epiretinal membrane surgery (2.3%), and in 3 of 70 cases after vitreomacular traction surgery (4.3%) (P = 0.14; log-rank test).

CONCLUSION

After a short-term follow-up, a lower rate of postoperative RD was observed in the 23-gauge group. Sutureless 23-gauge vitrectomy appears safe when considering the risk of postoperative RD. Prospective and long-term studies are still needed to confirm these results.

摘要

目的

比较 23 号无缝线玻璃体切除术与 20 号玻璃体切除术治疗黄斑手术后视网膜脱离（RD）的累积风险。

方法

进行了一项单中心回顾性比较研究，比较了因眼内膜、黄斑裂孔、玻璃体黄斑牵引和内界膜剥除而接受手术的眼。23 号组包括 2007 年 6 月至 2008 年 12 月连续手术的 349 只眼。20 号组包括 2003 年 10 月至 2007 年 9 月手术的 346 只眼。

结果

在 6 个月的随访后，23 号组的 RD 累积概率为 1.1%，20 号组为 3.5%（P=0.04）。在 23 号组的中位随访时间为 14 个月（范围 6-30 个月），20 号组为 30 个月（范围 6-72 个月），RD 的累积概率分别为 1.1%和 4.9%（P=0.04；对数秩检验）。总的来说，在 96 例黄斑裂孔手术后有 7 例（7.3%）发生 RD，在 478 例眼内膜手术后有 11 例（2.3%），在 70 例玻璃体黄斑牵引手术后有 3 例（4.3%）（P=0.14；对数秩检验）。