Xiang Wu, Fang Dong, Jiang Xintong, Zhang Zhaotian, Xiang Chuqi, Huang Shaofen, Zhang Shaochong, Wei Yantao
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, P.R. China.
Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen, Guangdong 518040, P.R. China.
Exp Ther Med. 2023 Aug 17;26(4):472. doi: 10.3892/etm.2023.12171. eCollection 2023 Oct.
Small-gauge vitrectomy has become popular due to its notable advantages, including less trauma, shortened convalescence and improved manoeuvrability. The aim of the present study was to compare the surgical outcomes of 27-gauge (27-G) vitrectomy with those of 25-gauge (25-G) vitrectomy in the management of proliferative diabetic retinopathy (PDR) with preoperative intravitreal injection of conbercept. The data of 48 consecutive patients with PDR (48 eyes) were retrospectively collected. The patients underwent conbercept intravitreal injection and pars plana vitrectomy with a 27-G group (23 eyes) or 25-G group (25 eyes) vitrectomy system. The operating time, suturing rate, endodiathermy rate, postoperative best-corrected visual acuity (BCVA), intraocular pressure (IOP) and complications were recorded. The mean postoperative BCVA at final follow-up was significantly improved compared with that at the baseline in both groups (P<0.001 for both). The differences in the mean BCVA changes between the two groups were not significant (P>0.99), and no differences were observed in the final central foveal thickness (P=0.51) between the two groups. The final IOP remained stable compared with that at the baseline in the 27-G group (P=0.36) and the 25-G group (P=0.05). The suturing rate was significantly decreased in the 27-G group compared with the 25-G group (P=0.04). There were no significant differences between the two groups in terms of the operating time (P=0.18), rate of endodiathermy use (P>0.99), iatrogenic retinal breaks (P=0.42) or postoperative recurrent vitreous haemorrhage (P>0.99). In addition, no case of ocular hypotony was observed in either group. In conclusion, 27-G vitrectomy was as efficient and safe as 25-G vitrectomy in the management of PDR in terms of operating time and complications. With reference to the literature, preoperative conbercept injection appears to assist in decreasing the incidence of intraoperative and postoperative complications.
小切口玻璃体切除术因其显著优势，包括创伤小、恢复时间缩短和可操作性提高，而变得流行起来。本研究的目的是比较27G玻璃体切除术与25G玻璃体切除术在术前玻璃体内注射康柏西普治疗增殖性糖尿病视网膜病变（PDR）中的手术效果。回顾性收集了48例连续PDR患者（48只眼）的数据。患者接受了康柏西普玻璃体内注射及采用27G组（23只眼）或25G组（25只眼）玻璃体切除系统的睫状体平坦部玻璃体切除术。记录手术时间、缝合率、眼内透热凝固率、术后最佳矫正视力（BCVA）、眼压（IOP）及并发症。两组患者末次随访时的平均术后BCVA均较基线时显著改善（两组均P<0.001）。两组平均BCVA变化的差异无统计学意义（P>0.99），两组间末次中央凹厚度差异无统计学意义（P=0.51）。27G组和25G组末次眼压与基线时相比均保持稳定（27G组P=0.36，25G组P=0.05）。27G组的缝合率较25G组显著降低（P=0.04）。两组在手术时间（P=0.18）、眼内透热凝固使用率（P>0.99）、医源性视网膜裂孔（P=0.42）或术后复发性玻璃体出血（P>0.99）方面无显著差异。此外，两组均未观察到低眼压病例。总之，在手术时间和并发症方面，27G玻璃体切除术在治疗PDR时与25G玻璃体切除术一样有效且安全。参考文献，术前注射康柏西普似乎有助于降低术中及术后并发症的发生率。
