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微切口玻璃体切割术(MIVS)术后的前瞻性远程医疗方案

Prospective Telemedicine Postoperative Protocol Following Microincision Vitrectomy Surgery (MIVS).

作者信息

Min Heun, Garcia-O'Farrill Noraliz, Garcia Patricia, Thomson Andrew, Hunter Allan A

机构信息

Oregon Eye Consultants LLC, Springfield, OR, USA.

Cascade Medical Research Institute LLC, Springfield, OR, USA.

出版信息

Curr Eye Res. 2025 Jul;50(7):745-751. doi: 10.1080/02713683.2025.2490768. Epub 2025 Apr 22.

DOI:10.1080/02713683.2025.2490768
PMID:40260705
Abstract

PURPOSE

Retrospective studies show a low proportion of postoperative (PO) complications or alterations in management after Microincision Vitrectomy Surgery (MIVS). To our knowledge, this is the first prospective analysis of a telemedicine alternative to the standard practice for PO visits after MIVS. The purpose of this study is to evaluate telemedicine for the management of postoperative visits (POV) following MIVS.

METHODS

Ongoing randomized, prospective study with 53 patients assigned (1:1) to two arms of POV schedules including Virtual Telemedicine visits (VT) In-person Telemedicine (IP) visits. POV schedules in both groups included visits on the same day after surgery and week(s) 1, 2, 8, and 12. Complete exams with visual acuity, intraocular pressure, and dilated fundus exams of the operative eye were performed by the retina surgeon on day 0, weeks 2 and 12 in both groups. Protocolized focused undilated exams on weeks 1 and 8 either remotely (VT group) or in-person (IP group). Statistical analyses included Mann-Whitney U tests between groups using Microsoft Excel.

RESULTS

Primary outcome, mean POV logMAR BCVA, showed no statistically significant difference (-value = 0.70) between VT and IP groups. Other pre- and post-surgical comparisons (e.g. IOP, RNFL score) showed no statistical differences. No post-surgical complications have been noted.

CONCLUSIONS

Telemedicine-assisted POV may be a safe and convenient alternative for patients undergoing uncomplicated MIVS, but additional and larger studies are needed.

摘要

目的

回顾性研究表明,微切口玻璃体切除术(MIVS)后术后并发症或管理变更的比例较低。据我们所知,这是首次对MIVS术后门诊的标准做法进行远程医疗替代方案的前瞻性分析。本研究的目的是评估远程医疗在MIVS术后门诊(POV)管理中的应用。

方法

正在进行的随机前瞻性研究,53名患者按1:1分配到两个POV计划组,包括虚拟远程医疗门诊(VT)和面对面远程医疗(IP)门诊。两组的POV计划都包括术后当天以及第1、2、8和12周的门诊。视网膜外科医生在两组的第0天、第2周和第12周对术眼进行包括视力、眼压和散瞳眼底检查的完整检查。在第1周和第8周,通过远程(VT组)或面对面(IP组)进行标准化的聚焦不散瞳检查。统计分析使用Microsoft Excel在组间进行曼-惠特尼U检验。

结果

主要结果,即平均POV logMAR BCVA,在VT组和IP组之间没有统计学显著差异(P值=0.70)。其他手术前后的比较(如眼压、视网膜神经纤维层评分)也没有统计学差异。未观察到术后并发症。

结论

对于接受无并发症MIVS的患者,远程医疗辅助的POV可能是一种安全方便的替代方案,但需要更多更大规模的研究。

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