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Comparative Study of 23-gauge Transconjunctival Sutureless Vitrectomy and Conventional 20-gauge Vitrectomy in Proliferative Diabetic Retinopathy

Author: LiDongFang
Tutor: ZhouZhanYu
School: Qingdao University
Course: Ophthalmology
Keywords: 23-gauge 20-gauge vitrectomy comparative study
CLC: R779.6
Type: Master's thesis
Year: 2011
Downloads: 94
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Abstract


Objective:Evaluate the characteristics of 23-gauge transconjunctival sutureless vitrectomy and conventional 20-gauge vitrectomy on proliferative diabetic retinopathy (PDR)Methods:Patients were recruited in our comparative retrospective study research included proliferative diabetic retinopathy were given 23-gauge vitrectomy and 20-gauge vitrectomy. The best corrected visual acuity(BCVA), intraocular pressure(IOP), operation time, break up time(BUT), Schirmer test and patient comfort investigation were recorded.Results:All the puncture were completed smoothly, extract the puncture occur subconjunctival hemorrhage, but it can absorbed in 2-3days after operation. The BCVA of 7 day,15days post operation was 4.18±0.03、4.22±0.02、respectively in 23-gauge group, while the counterpart in 20 gauge group was 4.08±0.03、4.12±0.03 (P<0.05). On the 1st postoperative day, there were 2 cases in 23G group with IOP<10mmHg,2 cases in 23G group and 5 cases in 20G groupwith IOP>21mmHg. All hypertension were controlled by medicine. The IOP of 1 day,7 days,1 month and 2 months post operation was18.7±8.9、17.6±6.3、17.9±9.0、15.8±7.5 mmHg respectively in 23 gauge group, while the counterpart in 20 gauge group was21.9±6.8、19.6±5.3、16.1±6.0、17.4±7.7 mm Hg(P<0.05). The time for scleral incision making was 245±23s and472±133s for 23G and 20G surgery respectively (P<0.05). The time for sclera incision closure was 161±83s and 531±92s for 23G and 20G surgery respectively (P<0.05). The total operation time was 2.2±0.4h and3.1±0.5h for 23G and 20G surgery respectively which is no difference between two groups (P>0.05).The corneal endothelium counter before surgery,7 days after surgery and 1 month after surgery was 2832±245、2711±291、2732±311 respectively for 23G, while the counterpart in 20 gauge group was 2745±323、2755±310、2822±261 respectively (P>0.05). There was no significant difference between pre- and postoperative corneal endothelium density with single vitrectomy and viteectomy combined with cataract extractin with posterior capsule integrity (P>0.05). Postoperative inflammation reaction(including conjunctival edema, aqueous flare and inflammation cells)were more severe in 20G group than 23G group (P>0.05). One of 23G group patients with diabetic retinopathy occurred casing drop, one case happened epiretinal membrane and one case happened the postoperatie vitreous hemorrhage.1 month after surgery slit lamp microscope examination results showed that conjunctival smooth surface, did not see the obvious scar tissue 23G group.Conclusion:23 gauge vitrectomy is superior in the ocular surface change, best corrected visual acuity post operation and patient comfort.23 gauge vitrectomy is not recommended for those patients with severe ocular trauma that may have choroidal detachment.

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CLC: > Medicine, health > Ophthalmology > Eye surgery and surgery
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