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一种斜面尖端、超高速度、25G 经睫状体平坦部玻璃体切割系统的临床结果。

Clinical outcomes of a beveled tip, ultra-high speed, 25-gauge pars plana vitrectomy system.

机构信息

Peregrine Eye and Laser Institute, Morning Star Center, 347 Gil Puyat Avenue, Bel Air, 1209, Makati City, Philippines.

Department of Ophthalmology and Visual Sciences, University of the Philippines, Manila, Philippines.

出版信息

BMC Ophthalmol. 2022 Feb 24;22(1):93. doi: 10.1186/s12886-022-02311-3.

Abstract

OBJECTIVE

To report the clinical outcomes of a 25-gauge, beveled-tip, 10,000 cuts-per-minute (cpm) microincisional vitrectomy surgery (MIVS) system.

METHODS

Prospective case series of eyes undergoing primary pars plana vitrectomy (PPV) for common vitreoretinal indications. Main outcome measures were: rate of achieving surgical objectives, operative times, number of surgical steps, use of ancillary instruments, corrected distance visual acuity (CDVA), and adverse events (AE).

RESULTS

The surgical objectives were achieved in all eyes. Mean total operative time (TOT), core, shave and total vitrectomy times were 1891 ± 890, 204 ± 120, 330 ± 320, 534 ± 389 s, respectively. Mean number of surgical steps was 4.3 ± 1.5. Mean number of ancillary instruments used was 4.5 ± 1.9. Mean CDVA improved by 0.53 ± 0.56 logMAR units (P < 0.001) 3 months postoperatively. AE included elevated IOP (8%), hypotony (6%), and re-detachment (2%). Majority (82%) had no postoperative discomfort. The number of surgical steps demonstrated a positive correlation with TOT (p < 0.05), number of ancillary instruments used (p < 0.05), and postoperative Day 1 IOP (p < 0.05). The number of times ancillary instrumentation was used demonstrated a positive correlation with TOT (p < 0.05).

CONCLUSION

Beveled-tip, 10,000 cpm MIVS system effectively and safely performs common VR procedures of varying complexity and may reduce operative times and use of ancillary instrumentation.

摘要

目的

报告一种 25 号、斜口、10000 转/分钟(cpm)的微创玻璃体切割手术(MIVS)系统的临床结果。

方法

前瞻性病例系列研究,纳入接受原发性睫状体平坦部玻璃体切除术(PPV)治疗常见玻璃体视网膜疾病的患者。主要观察指标为:手术目标的实现率、手术时间、手术步骤数、辅助器械的使用、矫正视力(CDVA)和不良事件(AE)。

结果

所有患者均达到手术目标。平均总手术时间(TOT)、核心、刮除和总玻璃体切割时间分别为 1891±890、204±120、330±320、534±389 秒。平均手术步骤数为 4.3±1.5 步。平均使用辅助器械数为 4.5±1.9 个。术后 3 个月平均 CDVA 提高 0.53±0.56 对数视力(logMAR)单位(P<0.001)。AE 包括眼压升高(8%)、低眼压(6%)和再脱离(2%)。大多数(82%)患者术后无不适。手术步骤数与 TOT(p<0.05)、辅助器械使用数量(p<0.05)和术后第 1 天眼压(p<0.05)呈正相关。辅助器械使用次数与 TOT 呈正相关(p<0.05)。

结论

斜口、10000 cpm 的 MIVS 系统可有效、安全地完成不同复杂程度的常见 VR 手术,可能缩短手术时间和辅助器械的使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef05/8867727/5971904348c1/12886_2022_2311_Fig1_HTML.jpg

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