Small-Gauge Pars Plana Vitrectomy A Report by the American Academy of Ophthalmology
Small-Gauge Pars Plana Vitrectomy A Report by the American Academy of Ophthalmology
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DOI：
10.1016/j.ophtha.2010.06.014
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发表时间：
2010-09-01
期刊：
影响因子：
13.7
通讯作者：
Ip, Michael S.
中科院分区：
文献类型：
--
作者：
Recchia, Franco M.;Scott, Ingrid U.;Ip, Michael S.
目的：回顾现有的同行评审出版物，以评估与小规格平坦部玻璃体切除术相关的安全性和视觉结果。方法：PubMed 和 Cochrane 图书馆数据库的文献检索最后一次于 2009 年 8 月 5 日进行，没有日期限制。搜索仅限于以英文发表的文章。这些检索检索了 328 篇文章，其中 76 篇被认为与主题相关，并根据证据强度进行评级。 结果：根据 II 级和 III 级证据，小规格玻璃体切除术的总体安全性与传统 20 规格玻璃体切除术的总体安全性相似，并提供了可比较的视力结果。两项比较研究报告称，25 号玻璃体切除术后感染性眼内炎的发病率有所增加，但在多项大型更新的研究中并未发现这一情况，这可能是由于病例选择和手术技术随着时间的推移而发生的变化。与20号玻璃体切除术相比，小规格玻璃体切除术患者不适和眼部炎症的程度显着降低，视力改善所需的时间也更短。结论：小规格玻璃体切除术的技术进步似乎可以提供与传统20号玻璃体切除术相当的视力益处，与传统20号玻璃体切除术相比，愈合更快，不适更少，不良事件发生率较低，可以接受。玻璃体切除术。随着手术技术的发展和临床经验的增长，持续的密切监测对于准确评估并发症是必要的。财务披露：专有或商业披露可在参考文献后找到。眼科 2010；117:1851-1857 (C) 2010 年，美国眼科学会。
Objective: To review available peer-reviewed publications to evaluate the safety profile and visual outcomes associated with small-gauge pars plana vitrectomy.Methods: Literature searches of the PubMed and the Cochrane Library databases were last conducted on August 5, 2009, with no date restrictions. The searches were limited to articles published in English. These searches retrieved 328 articles, of which 76 were deemed topically relevant and rated according to strength of evidence.Results: On the basis of level II and level III evidence, the overall safety profile of small-gauge pars plana vitrectomy is similar to that established for conventional 20-gauge pars plana vitrectomy and provides comparable visual acuity results. An increased incidence of infectious endophthalmitis after 25-gauge vitrectomy was reported in 2 comparative studies, but this was not found in multiple, larger, more recent studies, perhaps due to modifications in case selection and surgical technique over time. Compared with 20-gauge vitrectomy, small-gauge vitrectomy is associated with significantly lower levels of patient discomfort and ocular inflammation, and the time required for improvement in visual acuity is shorter.Conclusions: The technological advances of small-gauge vitrectomy seem to afford visual benefit comparable with that seen with traditional 20-gauge surgery, with more rapid healing, less discomfort, and an acceptably low incidence of adverse events comparable with those observed with conventional 20-gauge vitrectomy. As surgical techniques evolve and clinical experience grows, continued close surveillance is necessary for an accurate assessment of complications.Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references. Ophthalmology 2010;117:1851-1857 (C) 2010 by the American Academy of Ophthalmology.