摘要
目的 评估 2 5 G经结膜无缝合玻璃体切割手术系统 (TSV2 5 G)在黄斑疾病手术治疗中的应用价值。 方法 回顾分析应用 TSV2 5 G治疗 18例黄斑疾病患者的临床资料。 18例患者中 ,黄斑前膜 8例 ,特发性黄斑裂孔 3例 ,外伤性黄斑裂孔伴黄斑区视网膜下出血 3例 ,玻璃体黄斑牵引综合征 2例 ,糖尿病视网膜病变弥漫性黄斑水肿 2例 ;其中 ,男 13例 ,女 5例 ,年龄 2 5～ 73岁 ,患病时间 3.5～ 30 .0个月。手术使用 TSV2 5 G,切割速率 15 0 0次 / min,负压吸引 5 0 0～ 5 5 0 mm Hg(1mm Hg=0 .133k Pa) ,灌注瓶高度4 0～ 5 0 cm,手术中眼压维持在 2 9～ 35 mm Hg。手术后随访 2 .5～ 10 .0个月。 结果 18例患者均顺利完成手术。手术时间 2 6～ 4 4 min,平均手术时间 35 min,无玻璃体手术并发症。 1例患者手术中穿刺口漏水 ,用 8- 0可吸收缝线缝合。手术后平均住院时间 3.5 d。 6例患者视力恢复到 0 .8以上 ,占 33.3%。 12例手术前有黄斑水肿者手术后 3～ 6个月黄斑水肿完全消退 ,10例患者视物变形消失 ,2例患者视物变形减轻 ;黄斑裂孔患者 4例手术后视力无变化 ,2例视力增加。 结论 TSV2 5 G应用于黄斑疾病手术治疗 ,手术安全、省时、效果好。
Objective To evaluate the 25-gauge (25G) transconjunctival sutureless vitrectomy system (TSV25G) for macular diseases. Methods The clinical data of 18 patients with macular diseases treated by the TSV25G were retrospectively analyzed. The 18 patients included 13 men and 5 women, aged from 25 to 73 years. The disease course ranged from 3.5 to 10 months, including 8 epiretinal membrane, 3 idiopathic macular hole, 3 tranumatic macular hole with submacular heamorrhage, 2 vitreo-macular tractional syntrome and 2 diabetic macular edema. The surgical parameter installation was as follows: high speed cutter with rate of 1500 cuts per minute; the maximum aspiration with a TSV25G were 500-550 mmHg (1 mm Hg=0.133 kPa); the BSS bottle height was 40-50 cm; the intraocular pressure was 29-35 mmHg during the surgery. The postoperative follow-up period was 2.5-10 months. Results Eighteen patients had undergone the vitrectomy successfully with the operative time of 26-44 minutes (mean 35 minutes). No complication was found. Water leakage of the puncture site was found in 1 patient and was sewed up with 8-0 absorbable sutures. The mean time of inpatients were 3.5 days postoperatively. In the postoperative follow-up in 18 patients, the macular edema disappeared totally in 12 patients 3-6 months after the operation; the visual distortion disappeared in 10 and alleviated in 2; the visual acuity regained (0.8 or more) in 6 (33.3%), not changed in 4, and improved in 2. Conclusion TSV25G was safe, time-saving, and effective for macular diseases.
出处
《中华眼底病杂志》
CAS
CSCD
2004年第3期137-138,共2页
Chinese Journal of Ocular Fundus Diseases
