Han Guangjie, Zhai Jianwei, Huang Hongbo, He Limei, Wei Heruo, Wei Lirong, Wang Huanyan
Department of Ophthalmology, Liuzhou Red Cross Hospital, Eye Hospital of Liuzhou City, Liuzhou, Guangxi, China.
Front Med (Lausanne). 2025 Aug 26;12:1614668. doi: 10.3389/fmed.2025.1614668. eCollection 2025.
To evaluate the therapeutic efficacy and safety of 25-gauge (25G) 10,000 cpm (10K) beveled-tip microincision vitrectomy (MIVS) versus 25-gauge (25G) flat-tip MIVS in managing proliferative diabetic retinopathy (PDR).
This retrospective study involved 60 eyes with proliferative diabetic retinopathy (PDR) from 60 patients, all requiring epiretinal membrane removal. The patients were assigned to either the 25G 10K cpm beveled-tip MIVS group or the 25G flat-tip MIVS group. Surgical outcomes, including membrane removal efficiency, vitrectomy probe (VP) and microforceps exchanges, total procedure duration, vitrectomy time, and intraoperative complications, were documented. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), and postoperative complications were assessed during a 6-month follow-up period.
Fifty-eight eyes (from 58 patients) completed follow-up, including 30 eyes in the 25G 10K cpm beveled-tip group and 28 eyes in the 25G flat-tip group. During surgery, the 25G 10k cpm beveled-tip group demonstrated more effective membrane cutting ( = 0.001) and required fewer exchanges between the vitrectomy probe and microforceps ( = 0.001). The total surgery time and vitrectomy time were both reduced in this group ( = 0.001 and = 0.001, respectively). Additionally, fewer intraoperative hemostasis maneuvers were needed in the 25G 10K cpm beveled-tip group. All follow-up outcomes indicated no significant differences between the two groups.
In the surgical treatment of PDR, the 25G 10K cpm beveled-tip MIVS group showed no statistically significant difference compared to conventional 25G flat-tip MIVS in terms of visual acuity improvement and postoperative intraocular pressure. However, the former demonstrated advantages such as reduced surgical time, decreased intraoperative use of electrocoagulation, and fewer instrument exchanges within the eye, providing robust evidence for its efficacy in PDR surgical management.
评估25G 10,000次/分钟（10K）斜面尖端微切口玻璃体切除术（MIVS）与25G平尖端MIVS治疗增殖性糖尿病视网膜病变（PDR）的疗效和安全性。
这项回顾性研究纳入了60例患者的60只患有增殖性糖尿病视网膜病变（PDR）且均需行视网膜前膜剥除术的眼睛。将患者分为25G 10K次/分钟斜面尖端MIVS组或25G平尖端MIVS组。记录手术结果，包括膜剥除效率、玻璃体切除探头（VP）和显微镊的更换次数、总手术时长、玻璃体切除时间及术中并发症。在6个月的随访期内评估最佳矫正视力（BCVA）、眼压（IOP）及术后并发症。
58只眼（来自58例患者）完成随访，其中25G 10K次/分钟斜面尖端组30只眼，25G平尖端组28只眼。手术过程中，25G 10K次/分钟斜面尖端组的膜切割更有效（P = 0.001），且玻璃体切除探头与显微镊之间的更换次数更少（P = 0.001）。该组的总手术时间和玻璃体切除时间均缩短（分别为P = 0.001和P = 0.001）。此外，25G 10K次/分钟斜面尖端组所需的术中止血操作更少。所有随访结果表明两组之间无显著差异。
在PDR的手术治疗中，25G 10K次/分钟斜面尖端MIVS组与传统25G平尖端MIVS相比，在视力改善和术后眼压方面无统计学显著差异。然而，前者具有手术时间缩短、术中电凝使用减少以及眼内器械更换次数减少等优势，为其在PDR手术治疗中的疗效提供了有力证据。
