Goncu Tugba, Gurelik Gokhan, Hasanreisoglu Berati
Ophthalmology Department, Nevsehir Goverment Hospital, Nevsehir, Turkey.
Korean J Ophthalmol. 2012 Oct;26(5):339-46. doi: 10.3341/kjo.2012.26.5.339. Epub 2012 Sep 24.
To compare the efficacy and safety of 23-gauge transconjunctival vitrectomy with the conventional 20-gauge method in idiopathic epiretinal membrane and macular hole surgery.
Sixty-one consecutive patients undergoing vitrectomy for idiopathic epiretinal membrane and macular hole were recruited to either 20- or 23-gauge vitrectomy groups and prospectively evaluated. Surgical success rates, operating time, surgery-related complications, long-term visual outcomes, and postoperative ocular surface problems are compared in the two groups.
There were 31 eyes in the 20-gauge group and 33 eyes in the 23-gauge group. The macular hole closure rate after the first surgery was 83% and 90.9% in the 20-gauge and 23-gauge groups, respectively, with no significant difference between groups (p = 0.59). The success rate for idiopathic epiretinal membranes cases was 100% in both groups. There was no statistically significant difference between overall surgical times (p = 0.90). None of the patients in either group experienced postoperative complications of severe postoperative hypotony, vitreous hemorrhage or endophthalmitis, except one eye in the 20-gauge group, which was found to have retinal detachment. In both groups, statistically significant improvement in visual acuity was achieved 1-month postoperatively (p = 0.002) and thereafter at all postoperative visits (p < 0.05). The mean ocular surface scores were significantly lower in the 23-gauge group at all postoperative visits compared with the 20-gauge group scores (p = 0.001).
Transconjunctival 23-gauge vitrectomy appears to be as effective and safe as conventional 20-gauge vitrectomy in idiopathic epiretinal membrane and macular hole surgeries.
比较23G经结膜玻璃体切除术与传统20G方法在特发性视网膜前膜和黄斑裂孔手术中的疗效和安全性。
连续纳入61例因特发性视网膜前膜和黄斑裂孔接受玻璃体切除术的患者，分为20G或23G玻璃体切除术组，并进行前瞻性评估。比较两组的手术成功率、手术时间、手术相关并发症、长期视力结果和术后眼表问题。
20G组有31只眼，23G组有33只眼。20G组和23G组首次手术后黄斑裂孔闭合率分别为83%和90.9%，两组间无显著差异（p = 0.59）。两组特发性视网膜前膜病例的成功率均为100%。总体手术时间之间无统计学显著差异（p = 0.90）。除20G组有1只眼发生视网膜脱离外，两组均无患者出现严重术后低眼压、玻璃体积血或眼内炎等术后并发症。两组术后1个月视力均有统计学显著改善（p = 0.002），此后所有术后随访时视力均有改善（p < 0.05）。与20G组相比，23G组在所有术后随访时的平均眼表评分均显著更低（p = 0.001）。
在特发性视网膜前膜和黄斑裂孔手术中，经结膜23G玻璃体切除术似乎与传统20G玻璃体切除术一样有效和安全。
