Longer-term outcomes of transconjunctival sutureless 25-gauge vitrectomy
Longer-term outcomes of transconjunctival sutureless 25-gauge vitrectomy
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DOI：
10.1016/j.ajo.2004.12.002
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发表时间：
2005-05-01
影响因子：
4.2
通讯作者：
Hassan, TS
中科院分区：
文献类型：
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作者：
Ibarra, MS;Hermel, M;Hassan, TS
目的：报道经结膜无缝合玻璃体切割术的远期疗效。设计：回顾性、非对比、病例系列。方法：回顾最初45例(45只眼)由一位外科医生(T.S.H.)行TSV的病例。特发性视网膜前膜15例，顽固性糖尿病黄斑水肿11例，特发性黄斑裂孔10例，玻璃体积血9例。所有患者均获得至少6个月的随访。主要观察指标包括视力、眼压、术中并发症和术后并发症。结果：平均随访13个月(6~25个月)。术前平均视力为20/229，术后平均视力为20/65(P<；0.0001)。在统计学上，每个患者亚组的视力都有显著改善。术前眼压10~26 mm Hg，平均16.9 mm Hg。术后第1、1、4周平均眼压分别为14.6 mm Hg(847 Mm Hg)、17.6 mm Hg(8~38 mm Hg)和17.7 mm Hg(9~33 mm Hg)。无术中并发症发生。术后并发症：黄斑裂孔修补术后4周1例(2.2%)，视网膜前膜剥离6个月后1例(2.2%)，白内障加重23例(79.3%)。结论：TSV可以成功修复手术复杂的玻璃体视网膜病变。经过一年多的平均随访，并发症微乎其微，且无一例与手术的无缝合性有关。(C)2005，Elsevier Inc.保留所有权利。
PURPOSE: To report longer-term outcomes in eyes undergoing 25-gauge transconjunctival sutureless vitrectomy.DESIGN: Retrospective, noncomparative, case series.METHODS: Chart review of the initial 45 consecutive patients (45 eyes) that underwent TSV by one surgeon (T.S.H.) for idiopathic epiretinal membrane (n = 15), refractory diabetic macular edema (n = 11), idiopathic macular hole (n = 10), and nonclearing vitreous hemorrhage (n = 9). All patients had at least 6-month follow-up. Main outcome measures included visual acuity (VA), intraocular pressure, intraoperative complications, and postoperative complications.RESULTS: Mean follow-up was 13 months (range 6 to 25 months). Mean overall preoperative VA vs last postoperative VA was 20/229 and 20/65, respectively (P < .0001). Statistically significant VA improvement was seen for each patient subgroup. Mean preoperative intraocular pressure was 16.9 mm Hg (range 10-26 mm Hg). On postoperative day 1, week 1, and week 4, median intraocular pressure was 14.6 mm Hg (range 847 mm Hg), 17.6 mm Hg (range 8-38 mm Hg), and 17.7 mm Hg (range 9-33 mm Hg), respectively. No intraoperative complications occurred. Postoperative complications were 1 inferior retinal detachment (2.2%) 4 weeks after macular hole repair, 1 macular hole (2.2%) 6 months after epiretinal membrane peel, and 23 worsening cataracts in 29 phakic eyes (79.3%).CONCLUSIONS: Less surgically complex vitreoretinal pathology may be successfully repaired with TSV. After a mean follow,up of more than I year, minimal complications were seen, and none was specifically related to the sutureless nature of the procedure. (c) 2005 by Elsevier Inc. All rights reserved.