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20 号经结膜无缝线玻璃体切除术的安全性。

Safety of 20-gauge transconjunctival sutureless vitrectomy.

机构信息

Department of Ophthalmology, University of Geneva, Geneva, Switzerland.

出版信息

Ophthalmologica. 2013;230(4):207-14. doi: 10.1159/000346393. Epub 2013 Sep 12.

Abstract

PURPOSE

To study the safety of 20-gauge transconjunctival sutureless vitrectomy.

METHODS

Clinical data of patients who underwent 20-gauge transconjunctival sutureless vitrectomy for the first time, for various disorders, were reviewed retrospectively. The main outcome measures were the number of sclerotomies requiring suturing as well as the intra- and postoperative complications.

RESULTS

A total of 179 operations were performed. Indications for vitrectomy included 68 idiopathic epiretinal membranes, 26 macular holes, 23 phakic and 16 pseudophakic retinal detachments, and 46 various other, less common etiologies. Of these 179 operations, 166 (93%) were sutureless. Of the 537 sclerotomies created, 25 (5%) received a single transconjunctival-scleral suture. Intraoperative complications included premature dislodging of the cannulas in 2 sclerotomies and an iatrogenic horseshoe tear at 1 sclerotomy site. Postoperative complications comprised transient hypotony in 14 cases, subconjunctival gas in 2 cases, and choroidal effusion in 1 case. No serious complications (such as endophthalmitis) were observed.

CONCLUSION

20-gauge transconjunctival sutureless vitrectomy can be considered safe, as the intra- and postoperative complications observed are neither numerous nor significant. Sclerotomies appear to be safe and relatively easy to perform, without compromising the advantages of sutureless surgery.

摘要

目的

研究 20 号经结膜无缝线玻璃体切除术的安全性。

方法

回顾性分析首次接受 20 号经结膜无缝线玻璃体切除术治疗各种疾病的患者的临床资料。主要观察指标为需要缝合的巩膜切口数量以及术中及术后并发症。

结果

共进行了 179 例手术。玻璃体切除术的适应证包括 68 例特发性视网膜内膜、26 例黄斑裂孔、23 例有晶状体和 16 例无晶状体视网膜脱离,以及 46 例其他较少见的病因。在这 179 例手术中,166 例(93%)无需缝合。在创建的 537 个巩膜切口中,25 个(5%)接受了单次经结膜-巩膜缝合。术中并发症包括 2 个巩膜切口中的套管过早移位和 1 个巩膜切口中的医源性马蹄形撕裂。术后并发症包括 14 例短暂性低眼压、2 例结膜下积气和 1 例脉络膜积液。未观察到严重并发症(如眼内炎)。

结论

20 号经结膜无缝线玻璃体切除术安全可靠,观察到的术中及术后并发症既不常见也不严重。巩膜切口似乎是安全且相对容易操作的,不会影响无缝线手术的优势。

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