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经结膜无缝合27G微切口玻璃体切除术治疗糖尿病性玻璃体积血的疗效

Outcomes of transconjunctival sutureless 27-gauge micro-incision vitrectomy surgery in diabetic vitreous haemorrhage.

作者信息

Shahzadi Bashiran, Rizwi Syed Fawad, Qureshi Faisal Murtaza, Latif Kanwal, Mahmood Syed Asaad

机构信息

Dr. Bashiran Shahzadi, FCPS. Department of Ophthalmology, LRBT Free Eye Hospital, Karachi, Pakistan.

Prof. Syed Fawad Rizwi, FCPS. Department of Ophthalmology, LRBT Free Eye Hospital, Karachi, Pakistan.

出版信息

Pak J Med Sci. 2017 Jan-Feb;33(1):86-89. doi: 10.12669/pjms.331.11617.

Abstract

OBJECTIVE

To evaluate the visual outcomes of 27-gauge transconjunctival sutureless vitrectomy surgery and its complications in patients with diabetic vitreous hemorrhage.

METHODS

A quasi-experimental study was conducted where eighty seven eyes of 87 uncontrolled type II diabetes mellitus patients presenting with diabetic vitreous hemorrhage were selected to undergo 27-gauge transconjunctival sutureless micro-incision vitrectomy surgery. Main outcome measured was best corrected visual acuity (BCVA). Post-operative complications were also screened for at each visit. The follow ups were at post-operative day one, one month, three months and six months respectively.

RESULTS

Out of 87 patients, 52 (59.8%) were males and 35 (40.2%) were females. The mean age of the patients was 52.32 ± 6.78 years (95% CI: 53.13 - 55.57). For most of the patients, the BCVA improved progressively with each subsequent follow up visit. Pre-operative BCVA was 1.01 ± 0.206 logMar, compared to BCVA at final follow up of 0.44 ± 0.231 (p-value < 0.001). Six (6.9%) patients developed recurrent vitreous hemorrhage during the study period, four (4.6%) developed cataract, one (1.1%) had increased intraocular pressure and sub conjunctival hemorrhage was present in two (2.3%).

CONCLUSION

27-gauge micro-incision vitrectomy surgery is an effective sutureless surgery with favorable outcomes, in terms of vision, in patients with diabetic vitreous hemorrhage. The associated complications are few which can be easily managed.

摘要

目的

评估27G经结膜无缝线玻璃体切除术治疗糖尿病性玻璃体积血患者的视觉效果及其并发症。

方法

进行一项准实验研究,选取87例未控制的II型糖尿病性玻璃体积血患者的87只眼,行27G经结膜无缝线微小切口玻璃体切除术。主要观察指标为最佳矫正视力(BCVA)。每次随访时还筛查术后并发症。随访时间分别为术后1天、1个月、3个月和6个月。

结果

87例患者中,男性52例(59.8%),女性35例(40.2%)。患者平均年龄为52.32±6.78岁(95%CI:53.13 - 55.57)。对于大多数患者,每次后续随访时BCVA均逐渐改善。术前BCVA为1.01±0.206 logMar,最终随访时BCVA为0.44±0.231(p值<0.001)。6例(6.9%)患者在研究期间发生复发性玻璃体积血,4例(4.6%)发生白内障,1例(1.1%)眼压升高,2例(2.3%)出现结膜下出血。

结论

27G微小切口玻璃体切除术是一种有效的无缝线手术,对于糖尿病性玻璃体积血患者的视力预后良好。相关并发症较少,易于处理。

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