与用于黄斑疾病的标准25G系统相比，气下25G玻璃体切除术中的医源性视网膜裂孔

Iatrogenic retinal breaks in 25-gauge vitrectomy under air compared with the standard 25-gauge system for macular diseases.

作者信息

Reibaldi Michele, Rizzo Stanislao, Avitabile Teresio, Longo Antonio, Toro Mario D, Viti Francesca, Saitta Andrea, Giovannini Alfonso, Mariotti Cesare

机构信息

*Department of Ophthalmology, University of Catania, Catania, Italy; †Department of Ophthalmology, Santa Chiara Hospital, Pisa, Italy; and ‡Department of Ophthalmology, University of Ancona, Ancona, Italy.

出版信息

Retina. 2014 Aug;34(8):1617-22. doi: 10.1097/IAE.0000000000000112.

DOI:10.1097/IAE.0000000000000112

PMID:24651259

Abstract

PURPOSE

To evaluate the incidence rates of iatrogenic retinal breaks in eyes that underwent 25-gauge vitrectomy under air compared with 25-gauge standard vitrectomy for idiopathic macular holes or idiopathic epiretinal membranes.

METHODS

In this retrospective, comparative interventional study, 435 eyes were enrolled. In all patients after core vitrectomy and epiretinal/inner limiting membrane peeling, complete vitrectomy of the base was performed, respectively under air (air group) or under fluid infusion (standard group).

RESULTS

The number of eyes with iatrogenic retinal breaks was significantly lower in the air group than in standard group (4/197 and 16/238, 2% and 7%, respectively; P = 0.035). A postoperative retinal detachment developed in 2 eyes (1%) in the standard group, and in no eyes of the air group (0%). Factors related to the occurrence of retinal breaks were surgically induced posterior vitreous detachment (P = 0.006), standard vitrectomy (P = 0.023), and surgery for macular hole (P = 0.030).

CONCLUSION

The 25-gauge vitrectomy under air is associated with a lower incidence rate of retinal breaks compared with the standard 25-gauge vitrectomy.

摘要

目的

评估与25G标准玻璃体切除术相比，在气体填充下进行25G玻璃体切除术治疗特发性黄斑裂孔或特发性视网膜前膜时医源性视网膜裂孔的发生率。

方法

在这项回顾性、比较性干预研究中，纳入了435只眼睛。所有患者在进行核心玻璃体切除术和视网膜前/内界膜剥除术后，分别在气体填充下（气体组）或液体灌注下（标准组）进行玻璃体基底部的完全玻璃体切除术。

结果

气体组医源性视网膜裂孔的眼数显著低于标准组（分别为4/197和16/238，2%和7%；P = 0.035）。标准组有2只眼（1%）发生了术后视网膜脱离，气体组无眼发生（0%）。与视网膜裂孔发生相关的因素有手术诱导的玻璃体后脱离（P = 0.006）、标准玻璃体切除术（P = 0.023）以及黄斑裂孔手术（P = 0.030）。