*llinois Retina Associates, Chicago, Illinois; and †Department of Ophthalmology, Rush University Medical Center, Chicago, Illinois.
Retina. 2014 Apr;34(4):679-83. doi: 10.1097/IAE.0b013e3182a48972.
To evaluate the rate of sclerotomy suturing in a large series of primary 23-gauge vitrectomies.
Retrospective chart review of 23-gauge transconjunctival pars plana vitrectomies performed between 2008 and 2012 in a multisurgeon retina practice. Patients with a history of retinal surgery, combination of vitrectomy and scleral buckling surgery, or intraoperative conversion of a sclerotomy to 20-gauge were excluded from the study. Vitrectomies were divided into two types according to their degree of complexity and intraoperative use of instrumentation. Demographic and clinical data were gathered from the chart. Location and number of sutured sclerotomies were obtained from the operative report.
A total of 589 eyes from 569 patients were included in this study. At least 1 sclerotomy was sutured in 227 eyes (38.5%): 69 (30.4%) had 1 sutured sclerotomy, 52 (22.9%) had 2 sutured sclerotomies, and 106 (46.7%) had 3 sutured sclerotomies. Sclerotomy suturing was significantly related to the surgical technique (P < 0.001), type of tamponade agent (P = 0.048), and complexity of the vitrectomy (P < 0.001). The incidence of postoperative hypotony at Day 1 was 2.2% and all cases returned to normal intraocular pressure at 1 week. There were no recognized complications related to sclerotomies regardless of suturing.
The factors that increased the rate of sclerotomy suturing were the absence of tamponade agent and higher complexity of the procedure. There was a high variability in the rate of suturing between the surgeons.
评估在大量原发性 23 号auge 玻璃体切除术中进行巩膜缝合的比例。
对 2008 年至 2012 年间在多外科医生视网膜实践中进行的 23 号auge 经结膜经睫状体平坦部玻璃体切除术的回顾性图表审查。排除有视网膜手术史、玻璃体切除术和巩膜扣带术联合、或术中将巩膜切口转换为 20 号auge 的患者。根据手术的复杂性和术中使用的器械，将玻璃体切除术分为两种类型。从图表中收集人口统计学和临床数据。从手术报告中获得缝合巩膜切口的位置和数量。
本研究共纳入 569 例患者的 589 只眼。至少缝合 1 个巩膜切口的有 227 只眼（38.5%）：69 只眼（30.4%）缝合 1 个巩膜切口，52 只眼（22.9%）缝合 2 个巩膜切口，106 只眼（46.7%）缝合 3 个巩膜切口。巩膜缝合与手术技术（P < 0.001）、眼内填充物类型（P = 0.048）和玻璃体切除术的复杂性（P < 0.001）显著相关。术后第 1 天发生低眼压的比例为 2.2%，所有病例在 1 周内恢复正常眼压。无论是否缝合，均未发现与巩膜切口相关的并发症。
增加巩膜缝合率的因素是无眼内填充物和手术过程更为复杂。外科医生之间的缝合率差异很大。
