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25G微创玻璃体切割手术治疗糖尿病性玻璃体积血的视觉预后

Visual outcome of 25-gauge microincision vitrectomy surgery in diabetic vitreous haemorrhage.

作者信息

Khan Burhan Abdul Majid, Rizvi Syed Fawad, Mahmood Syed Asaad, Mal Washoo, Zafar Shakir

机构信息

Dr. Burhan Abdul Majid Khan, FCPS (Ophth). Ophthalmologist, LRBT Free Base Eye Hospital, Korangi 2 ½, Karachi, Pakistan.

Dr. Syed Fawad Rizvi, FCPS (Ophth), MCPS (Ophth). Chief Consultant Ophthalmologist, LRBT Free Base Eye Hospital, Korangi 2 ½, Karachi, Pakistan.

出版信息

Pak J Med Sci. 2015 Sep-Oct;31(5):1197-200. doi: 10.12669/pjms.315.7182.

Abstract

OBJECTIVE

To assess the visual outcome and complications of 25-gauge micro incision vitrectomy surgery (MIVS) in diabetic vitreous haemorrhage.

METHODS

This Quasi Experimental study was conducted at LRBT, Tertiary eye care hospital Karachi, from February 2012 to January 2013. Sixty eyes of sixty patients with uncontrolled type II diabetes mellitus (DM) were included. There were 43 (71.7%) males and 17 (28.3%) females. Age range was 40 - 60 years. All randomly selected patients underwent 25-gauge sutureless micro incision vitrectomy surgery for diabetic vitreous haemorrhage. Main outcomes measured were best corrected visual acuity (BCVA) assessed with logMAR and post-operative complications. Follow ups were at one day, one week, one month, three months and six months post-operatively.

RESULT

Best corrected visual acuity (BCVA) gradually improved in majority of subjects in each subsequent follow up visit. Preoperative visual acuity was 1.023 ±0.226 logMAR, which was improved after final follow up to 0.457±0.256 and P-value was < 0.001. Five patients developed recurrent vitreous haemorrhage during study period, one patient developed cataract (1.7%), one (1.7%) had ocular hypotony defined as intraocular pressure < 5 mmHg and one (1.7%) developed endophthalmitis.

CONCLUSION

25-gauge micro incision vitrectomy surgery (MIVS) is an effective sutureless parsplana vitrectomy surgery which has good visual outcome in diabetic vitreous haemorrhage with minimum manageable complications.

摘要

目的

评估25G微创玻璃体切除术(MIVS)治疗糖尿病性玻璃体积血的视觉效果及并发症。

方法

本准实验研究于2012年2月至2013年1月在卡拉奇三级眼科护理医院LRBT进行。纳入60例II型糖尿病(DM)控制不佳患者的60只眼。其中男性43例(71.7%),女性17例(28.3%)。年龄范围为40 - 60岁。所有随机选取的患者均接受25G无缝合微创玻璃体切除术治疗糖尿病性玻璃体积血。主要测量指标为采用对数最小分辨角视力(logMAR)评估的最佳矫正视力(BCVA)及术后并发症。术后随访时间点为术后1天、1周、1个月、3个月和6个月。

结果

在随后的每次随访中,大多数受试者的最佳矫正视力(BCVA)逐渐提高。术前视力为1.023±0.226 logMAR,末次随访时提高至0.457±0.256,P值<0.001。研究期间有5例患者发生复发性玻璃体积血,1例患者发生白内障(1.7%),1例(1.7%)发生眼压<5 mmHg的低眼压,1例(1.7%)发生眼内炎。

结论

25G微创玻璃体切除术(MIVS)是一种有效的无缝合睫状体平坦部玻璃体切除术,治疗糖尿病性玻璃体积血时视觉效果良好,并发症易于处理且发生率低。

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