Bajgai Priya, Tigari Basavraj, Singh Ramandeep
Advanced Eye Centre, Post-graduate Institute for Medical Education and Research, Sector 12, Chandigarh, 160012, India.
Int Ophthalmol. 2018 Dec;38(6):2295-2301. doi: 10.1007/s10792-017-0721-1. Epub 2017 Oct 4.
To compare the outcome of 23-gauge as compared with 25-gauge transconjunctival sutureless vitrectomy (TSV) in the management of dislocated intraocular lenses (IOLs).
Retrospective, non-consecutive, comparative, interventional case series.
Patients with dislocated intraocular lens who underwent sutureless PPV using either 23-gauge or 25-gauge instruments.
The patients who presented with a dislocated IOL, underwent TSV with repositioning of the intraocular lens, either in the sulcus or scleral-fixated sutured/glued.
Of the total 61 eyes, 33 (54.09%) underwent 23-gauge TSV and 28 (45.90%) underwent 25-gauge TSV. The mean logMAR BCVA at baseline and 6 months after surgery was 0.8 and 0.46 in the 23-gauge group, and 0.82 and 0.47 in the 25-gauge group. There was no significant difference in logMAR BCVA values between the two groups at any time point of time during the follow-up. The mean postoperative IOP on postoperative day 1 was 14.76 ± 5.4 in 23-gauge group and 17.57 ± 7.9 in the 25-gauge group (p = 0.10). Retinal break was noticed intraoperatively in two cases in 23-gauge group and in three cases in 25-gauge group (p = 0.509). Postoperative complications included IOL decentration in one case of 23-gauge vitrectomy and two cases in 25-gauge group (p = 0.5), cystoid macular edema in four patients in 23-gauge group and six cases of 25-gauge group (p = 0.3) and retinal detachment in one case in each group (p = 0.9).
25-gauge appears to be as safe and as effective as 23-gauge TSV in the management of dislocated intraocular lenses.
比较23G与25G经结膜无缝线玻璃体切除术（TSV）在处理脱位人工晶状体（IOL）方面的效果。
回顾性、非连续性、比较性、干预性病例系列。
使用23G或25G器械行无缝线玻璃体切割术治疗人工晶状体脱位的患者。
对出现人工晶状体脱位的患者行TSV并将人工晶状体复位，植入睫状沟或行巩膜固定缝合/粘贴。
在总共61只眼中，33只眼（54.09%）接受了23G TSV，28只眼（45.90%）接受了25G TSV。23G组基线和术后6个月时的平均logMAR最佳矫正视力（BCVA）分别为0.8和0.46，25G组分别为0.82和0.47。随访期间两组在任何时间点的logMAR BCVA值均无显著差异。23G组术后第1天的平均眼压为14.76±5.4，25G组为17.57±7.9（p = 0.10）。23G组术中发现2例视网膜裂孔，25G组发现3例（p = 0.509）。术后并发症包括23G玻璃体切除术组1例人工晶状体偏位，25G组2例（p = 0.5）；23G组4例患者发生黄斑囊样水肿，25G组6例（p = 0.3）；两组各有1例视网膜脱离（p = 0.9）。
在处理脱位人工晶状体方面，25G TSV似乎与23G TSV一样安全有效。
