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一项前瞻性、随机临床试验比较了 23G 经睫状体平坦部玻璃体切除术后行巩膜环扎缝合时使用普通缝线与聚乳酸 910(薇乔)缝线的效果。

A PROSPECTIVE, RANDOMIZED TRIAL COMPARING PLAIN GUT TO POLYGLACTIN 910 (VICRYL) SUTURES FOR SCLEROTOMY CLOSURE AFTER 23-GAUGE PARS PLANA VITRECTOMY.

机构信息

Mid Atlantic Retina, The Retina Service of Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.

Bascom Palmer Eye Institute, University of Miami, Miami, Florida.

出版信息

Retina. 2018 Jun;38(6):1216-1219. doi: 10.1097/IAE.0000000000001684.

Abstract

PURPOSE

To report a prospective, randomized comparative study assessing clinical outcomes of plain gut versus polyglactin 910 (PG910) sutures for sclerotomy closure after 23-gauge pars plana vitrectomy.

METHODS

A single-masked, randomized, prospective study was undertaken with 49 eyes of 49 patients undergoing 23-gauge pars plana vitrectomy randomized to sclerotomy closure with either plain gut suture, PG910 (Vicryl) suture or a combination of the two. Assessment was based on both a postoperative pain scale and a standardized assessment of scleral inflammation at each suture site.

RESULTS

No wound leakage was noted postoperatively in any patient. Across all groups, scleral inflammation was significantly higher at the PG910 suture sites compared with the plain gut suture sites at both the 1-week (P = 0.04) and 1-month postoperative visits (P < 0.001). Patients with PG910 sutures reported greater pain at the 1-month postoperative visit than those with plain gut sutures (P = 0.018).

CONCLUSION

This prospective study suggests improved tolerability and reduced inflammation using plain gut suture compared with an 8-0 PG910 suture to close 23-gauge sclerotomies.

摘要

目的

报告一项前瞻性、随机对照研究,评估 23G 经睫状体平坦部玻璃体切割术后使用普通缝线与聚甘醇 910(PG910)缝线缝合巩膜切口的临床效果。

方法

对 49 例(49 只眼)行 23G 经睫状体平坦部玻璃体切割术的患者进行单盲、随机、前瞻性研究,随机分为使用普通缝线、PG910(薇乔)缝线或两者联合缝合巩膜切口。评估基于术后疼痛评分和每个缝线部位的巩膜炎症的标准化评估。

结果

所有患者术后均未出现伤口渗漏。在所有组中,PG910 缝线部位的巩膜炎症在术后 1 周(P = 0.04)和 1 个月(P < 0.001)时均显著高于普通缝线部位。PG910 缝线组患者在术后 1 个月时报告的疼痛比普通缝线组更严重(P = 0.018)。

结论

与使用 8-0PG910 缝线相比,本前瞻性研究表明使用普通缝线闭合 23G 巩膜切口具有更好的耐受性和更低的炎症反应。

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