*Department of Ophthalmology, Linköping University Hospital, Linköping, Sweden; and †Department of Anterior Segment Disorders, Glaucoma, Neuro-Ophthalmology and Oculoplastics, St. Erik Eye Hospital, Stockholm, Sweden.
Retina. 2014 Jan;34(1):142-8. doi: 10.1097/IAE.0b013e3182947b29.
The aim of the study was to retrospectively review indications, intraoperative and postoperative complications, and outcomes of combined coaxial microincision cataract surgery and 23-gauge vitrectomy for posterior segment disease.
The outcomes and findings of surgery in 50 patients (50 eyes) who underwent coaxial microincision cataract surgery and foldable intraocular lens implantation combined with 23-gauge vitrectomy for a variety of indications between January 2010 and March 2012.
No posterior capsule tear was observed during surgery. Intraoperatively, a retinal break was found in 9 eyes (18%), which were successfully treated with laser and/or cryotherapy. Corneal suture was done in 6 eyes (12%), 5 of them left and 1 right. Sclerotomy was sutured in 2 left and 2 right eyes, respectively, a total of 4 eyes (8%). In 1 case, 23-gauge vitrectomy was converted to 20-gauge vitrectomy. The postoperative intraocular pressure (millimeters of mercury, mean ± standard deviation) was 16.7 ± 9.8. Hypotony (intraocular pressure < 9 mmHg) occurred in 9 eyes (18%). In 1 eye (2%) posterior iris synechia were observed 2 weeks after surgery, and intraocular pressure was >40 mmHg. Intraocular pressure was normalized after Nd:YAG laser iridotomy. Fibrin reaction in the anterior chamber was observed in 1 eye (2%) Day 1 after surgery. Posterior capsule opacification, which required Nd:YAG laser capsulotomy, was observed in 11 eyes (22%) during the follow-up.
Combined sutureless coaxial microincision cataract surgery and 23-gauge vitrectomy offers the advantages of both coaxial microincision cataract surgery (less wound leakage, good anterior chamber stability, and safety) and 23-gauge vitrectomy (decreased inflammation and faster rehabilitation after surgery).
本研究旨在回顾分析同轴微切口白内障手术联合 23G 玻璃体切割术治疗后节疾病的适应证、术中及术后并发症和结果。
回顾分析 2010 年 1 月至 2012 年 3 月间 50 例（50 只眼）各种适应证患者行同轴微切口白内障手术联合折叠式人工晶状体植入术和 23G 玻璃体切割术的结果和发现。
术中未发生后囊膜破裂。9 只眼（18%）术中发现视网膜裂孔，通过激光和/或冷冻治疗成功处理。6 只眼（12%）行角膜缝线，其中 5 只为左眼，1 只为右眼。2 只左眼和 2 只右眼分别行巩膜穿刺缝线，共 4 只眼（8%）。1 例 23G 玻璃体切割术转换为 20G 玻璃体切割术。术后眼压（毫米汞柱，平均值±标准差）为 16.7±9.8。9 只眼（18%）发生低眼压（眼压<9mmHg）。术后 2 周 1 只眼（2%）观察到后发性虹膜粘连，眼压>40mmHg。Nd:YAG 激光虹膜切开术后眼压恢复正常。术后 1 天 1 只眼（2%）观察到前房纤维蛋白反应。在随访中，11 只眼（22%）观察到后囊混浊需要 Nd:YAG 激光后囊切开术。
同轴微切口白内障手术联合 23G 玻璃体切割术具有同轴微切口白内障手术（伤口漏液少、前房稳定性好、安全性高）和 23G 玻璃体切割术（术后炎症反应轻、恢复快）的优点。
