摘要
目的观察23G玻璃体切割手术巩膜切口缝合方式与手术后眼压的关系。方法前瞻性临床研究。首次行23G微创玻璃体切割手术的玻璃体视网膜疾病患者80例80只眼纳入研究，排除巩膜切口闭合不良需缝合者。患眼矫正视力手动～0．2；眼压7．9～19．8mmHg（1mmHg=0．133kPa），平均眼压（13．9±1．8）mmHg。按随机数字表法随机将患眼分为手术后缝合3个巩膜切口组（A组）、缝合上方2个巩膜切H下方灌注口不予缝合组（B组）、免缝合巩膜切口组（C组），分别为20、20、40只眼。所有患者均行单纯23G玻璃体切割手术。观察手术后1、7、14d矫正视力；1、3、7、14d眼压。结果手术后1、7、14d患眼矫正视力分别为0．1～0．3、0．2～0．5、0．3～0．8。手术后1、3、7、14d，A、B组患眼均未发生低眼压。C组患眼手术后l、3、7d发生低眼压为13、5、2只眼，分别占C组患眼的32．5％、12．5％、5．0Vo；手术后14d，无低眼压发生。手术后1d发生眼压〈5mmHg的严重低眼压7只眼，占C组患眼的17．5％。手术后不同时间点，C组与A、B组患眼低眼压发生率比较，差异有统计学意义（x2=16．82，P=0．007）。C组低眼压发生率之间比较，差异有统计学意义（x2=11．64，P=0．003）。手术后不同时间点，A、B组患眼眼压之间比较，差异无统计学意义（F=1．618，P=0．205）。手术后1、3d，C组患眼眼压与A、B组患眼眼压比较，差异均有统计学意义（F=9．351，P=0．000）；手术后7、14d，C组患眼眼压与A、B组患眼眼压比较，差异均无统计学意义（F=0．460，P=0．633）。结论23G玻璃体切割手术巩膜切口缝合与否与手术后低眼压的发生密切相关。缝合上方2个巩膜切口，可以防止手术后低眼压的发生；手术完毕巩膜切口闭合尚可的患者可以不缝合。
Objective To observe the relationship between the suturing patterns to close the seleral incision and postoperative intraocular pressure （IOP） in 23G minimally invasive vitrectomy. Methods Eighty eyes of 80 patients with vitreoretinal diseases, who were treated with primary 230 minimally invasive vitrectomy, were enrolled in this prospective clinical study. Patients with poor closed scleral incision which need suturing were excluded from this study. The corrected visual acuity ranged from hand movement to 0.2. The IOP ranged from 7.9 to 19.8 mm Hg （1 mm Hg=0. 133 kPa）, with the mean of （13.9-1.8） mm Hg. The eyes were randomly divided into three groups： group A （20 eyes）, suturing all three scleral puncture after vitrectomy; group 13 （20 eyes）, suturing only two upper scleral puncture, but not the lower infusion puncture after vitrectomy; group C （40 eyes）, no suturing for all 3 scleral puncture after vitrectomy. All patients underwent 23（; vitrectomy only. The corrected visual acuity and I（）P were observed after surgery. Results The corrected visual acuity were 0. 1 - 0.3, 0.2 - 0.5, 0.3 0.8 in one, seven and 14 days after surgery, respectively. No one in group A, t3, experienced hypotony in one, three, seven and 14 days after surgery. Thirteen （32.5%）, five （12.5 %）, two eyes （5.0%） in group C experienced hypotony in one, three and seven days after surgery. Seven eyes （17.5%） experienced severehypotony （〈5 mm Hg） in 14 day after surgery in group C. The difference was statistically significant compared the incidence of hypotony in group C with group A, B respectively at different time points after surgery （X2= 16.82, P= 0. 007）. The difference was statistically significant compared the incidence of hypotony in group C at different time points after surgery （X2=11.64, P=0.003）. The difference was no significant compared theIOP between group A and B at different time points after surgery （F=1.618, P=0.205）. Compared the IOP of group C to group A and
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2013年第6期589-592,共4页
Chinese Journal of Ocular Fundus Diseases
关键词
外科手术
微创性
副作用
玻璃体切除术
低眼压
预防和控制
Surgical procedures, minimally invasive/adverse effects
Vitrectomy
Ocularhypotension/prevention ＆control
