Wu Jian-Guo, Wei Rui-Hua, Liu Ai-Hua, Zhou Xiao-Xu, Sun Guo-Ling, Li Xiao-Rong
Tianjin Medical University Eye Center, Tianjin, China.
Clin Ophthalmol. 2011;5:901-5. doi: 10.2147/OPTH.S18963. Epub 2011 Jun 30.
The purpose of this prospective, interventional, comparative case series was to evaluate the efficiency and feasibility of a disposable sutureless silicone lens ring for corneal contact lens stabilization during combined 23-gauge vitrectomy and cataract surgery.
We developed a ring consisting of a single silicone component with three footplates along the ring margin to fit cannulae for holding conventional contact lenses. Thirty eyes from 30 patients with cataract and vitreoretinal disease were included, and divided into two matched groups according to disease type and ring used. In Group A, we used a 23-gauge transconjunctival vitrectomy system and a disposable sutureless silicone lens ring (n = 15). In Group B, we used a 23-gauge transconjunctival vitrectomy system and a conventional metal lens ring (n = 15). The main outcome measures were: time required for vitrectomy preparation, rate of intraoperative corneal limbus bleeding, and limbus scar rate at the final follow-up visit.
Thirty cases were successfully completed. The average vitrectomy preparation time was less in Group A than in Group B (P < 0.01), and the average preparation time saved was 3.94 minutes. None of the Group A patients had intraoperative bleeding or postoperative scarring, whereas all 15 Group B cases had bleeding and five had scarring. There was a statistically significant difference between Group A and Group B for these complications (P ≤ 0.05).
This report demonstrates the advantages of using a sutureless silicone ring during combined 23-gauge vitrectomy and cataract surgery. Using this method could allow extra time for the surgeon to pay more attention to complex vitreoretinal procedures.
本前瞻性、干预性、比较性病例系列研究旨在评估一种一次性无缝合硅胶晶状体环在23G玻璃体切割联合白内障手术中用于稳定角膜接触镜的有效性和可行性。
我们研发了一种由单一硅胶部件构成的环,其环缘有三个脚板,以适配用于固定传统接触镜的套管。纳入30例患有白内障和玻璃体视网膜疾病患者的30只眼,根据疾病类型和所使用的环将其分为两个匹配组。A组使用23G经结膜玻璃体切割系统和一次性无缝合硅胶晶状体环(n = 15)。B组使用23G经结膜玻璃体切割系统和传统金属晶状体环(n = 15)。主要观察指标为:玻璃体切割准备所需时间、术中角膜缘出血率以及末次随访时的角膜缘瘢痕率。
30例手术均成功完成。A组的平均玻璃体切割准备时间比B组短(P < 0.01),平均节省准备时间3.94分钟。A组患者术中均未出血或术后形成瘢痕,而B组的15例患者均有出血,5例有瘢痕形成。两组在这些并发症方面存在统计学显著差异(P ≤ 0.05)。
本报告证明了在23G玻璃体切割联合白内障手术中使用无缝合硅胶环的优势。采用这种方法可为手术医生留出额外时间,使其能更多地关注复杂的玻璃体视网膜手术操作。