中华眼视光学与视觉科学杂志
中華眼視光學與視覺科學雜誌
중화안시광학여시각과학잡지
CHINESE JOURNAL OF OPTOMETRY OPHTHALMOLOGY AND VISUAL SCIENCE
2011年
3期
214-217
,共4页
玻璃体切除术%屈光,眼%外科手术,微创
玻璃體切除術%屈光,眼%外科手術,微創
파리체절제술%굴광,안%외과수술,미창
Vitrectomy%Refraction,ocular%Surgical procedures,minimally invasive
目的 对比分析25-gauge(G)微创玻璃体视网膜手术与20-G手术术后眼屈光稳定性.方法 前瞻性随机病例对照研究.选取121例(121眼)需行玻璃体视网膜手术的眼底病患者,根据随机数字表随机分为A、B两组.A组61眼采用常规20-G玻璃体切割手术,B组60眼采用25-G微创玻璃体切割手术,对比观察术前与术后1周、4周和12周视力、屈光度、角膜地形图改变.数据采用卡方检验、独立样本t检验、单因素方差分析、Mann-Whitney非参数检验进行分析.结果 术后1周和4周,B组视力优于A组(x2=8.81、6.65,P均＜0.05).A组术后屈光度向远视漂移,在术后12周回归至接近术前水平.B组术后屈光度向近视漂移.A组术后1周、4周、12周较术前改变的平均球镜度为(+1.93±0.07)D、(+1.06±0.04)D、(+0.15±0.03)D,较术前改变的平均散光度为(1.62±0.07)D、(1.05±0.05)D、(0.41±0.03)D.B组术后1周、4周、12周较术前改变的平均球镜度为(-0.06±0.02)D、(-0.04±0.03)D、(-0.03±0.02)D,较术前改变的平均散光度为(0.05±0.01)D、(0.03±0.01)D、(0.03±0.02)D.术后1周、4周、12周球镜度改变在两组中差异存在统计学意义(t=200.6、159.3、26.0,P均＜0.01).术后各时间段散光度改变在两组中差异存在统计学意义(t=173.4、156.3、82.3,P均＜0.01).A组角膜散光屈光率(SimK1-K2)、表面不对称指数(SAI)、表面规则指数(SRI)在各个时间点的差异有统计学意义(F=4.21、3.44、3.28,P＜0.05),而B组患者各角膜地形参数在术前、术后各时间段差异无统计学意义.A、B两组之间在术后短期内角膜SimK1-K2、SAI、SRI的改变量差异有统计学意义(U=51.5、45.5、47.0,P＜0.05).结论 与20-G常规玻璃体切割手术相比,25-G微创玻璃体视网膜手术后眼屈光稳定性更好,可获得更完善的视功能.
目的 對比分析25-gauge(G)微創玻璃體視網膜手術與20-G手術術後眼屈光穩定性.方法 前瞻性隨機病例對照研究.選取121例(121眼)需行玻璃體視網膜手術的眼底病患者,根據隨機數字錶隨機分為A、B兩組.A組61眼採用常規20-G玻璃體切割手術,B組60眼採用25-G微創玻璃體切割手術,對比觀察術前與術後1週、4週和12週視力、屈光度、角膜地形圖改變.數據採用卡方檢驗、獨立樣本t檢驗、單因素方差分析、Mann-Whitney非參數檢驗進行分析.結果 術後1週和4週,B組視力優于A組(x2=8.81、6.65,P均＜0.05).A組術後屈光度嚮遠視漂移,在術後12週迴歸至接近術前水平.B組術後屈光度嚮近視漂移.A組術後1週、4週、12週較術前改變的平均毬鏡度為(+1.93±0.07)D、(+1.06±0.04)D、(+0.15±0.03)D,較術前改變的平均散光度為(1.62±0.07)D、(1.05±0.05)D、(0.41±0.03)D.B組術後1週、4週、12週較術前改變的平均毬鏡度為(-0.06±0.02)D、(-0.04±0.03)D、(-0.03±0.02)D,較術前改變的平均散光度為(0.05±0.01)D、(0.03±0.01)D、(0.03±0.02)D.術後1週、4週、12週毬鏡度改變在兩組中差異存在統計學意義(t=200.6、159.3、26.0,P均＜0.01).術後各時間段散光度改變在兩組中差異存在統計學意義(t=173.4、156.3、82.3,P均＜0.01).A組角膜散光屈光率(SimK1-K2)、錶麵不對稱指數(SAI)、錶麵規則指數(SRI)在各箇時間點的差異有統計學意義(F=4.21、3.44、3.28,P＜0.05),而B組患者各角膜地形參數在術前、術後各時間段差異無統計學意義.A、B兩組之間在術後短期內角膜SimK1-K2、SAI、SRI的改變量差異有統計學意義(U=51.5、45.5、47.0,P＜0.05).結論 與20-G常規玻璃體切割手術相比,25-G微創玻璃體視網膜手術後眼屈光穩定性更好,可穫得更完善的視功能.
목적 대비분석25-gauge(G)미창파리체시망막수술여20-G수술술후안굴광은정성.방법 전첨성수궤병례대조연구.선취121례(121안)수행파리체시망막수술적안저병환자,근거수궤수자표수궤분위A、B량조.A조61안채용상규20-G파리체절할수술,B조60안채용25-G미창파리체절할수술,대비관찰술전여술후1주、4주화12주시력、굴광도、각막지형도개변.수거채용잡방검험、독립양본t검험、단인소방차분석、Mann-Whitney비삼수검험진행분석.결과 술후1주화4주,B조시력우우A조(x2=8.81、6.65,P균＜0.05).A조술후굴광도향원시표이,재술후12주회귀지접근술전수평.B조술후굴광도향근시표이.A조술후1주、4주、12주교술전개변적평균구경도위(+1.93±0.07)D、(+1.06±0.04)D、(+0.15±0.03)D,교술전개변적평균산광도위(1.62±0.07)D、(1.05±0.05)D、(0.41±0.03)D.B조술후1주、4주、12주교술전개변적평균구경도위(-0.06±0.02)D、(-0.04±0.03)D、(-0.03±0.02)D,교술전개변적평균산광도위(0.05±0.01)D、(0.03±0.01)D、(0.03±0.02)D.술후1주、4주、12주구경도개변재량조중차이존재통계학의의(t=200.6、159.3、26.0,P균＜0.01).술후각시간단산광도개변재량조중차이존재통계학의의(t=173.4、156.3、82.3,P균＜0.01).A조각막산광굴광솔(SimK1-K2)、표면불대칭지수(SAI)、표면규칙지수(SRI)재각개시간점적차이유통계학의의(F=4.21、3.44、3.28,P＜0.05),이B조환자각각막지형삼수재술전、술후각시간단차이무통계학의의.A、B량조지간재술후단기내각막SimK1-K2、SAI、SRI적개변량차이유통계학의의(U=51.5、45.5、47.0,P＜0.05).결론 여20-G상규파리체절할수술상비,25-G미창파리체시망막수술후안굴광은정성경호,가획득경완선적시공능.
Objective To compare the changes in refractive status after 25-gauge sutureless vitrectomy and 20-gauge standard vitrectomy. Methods One hundred and twenty-one eyes of 121 patients who presented with vitreoretinal disease were included in this prospective study. Patients were randomly divided into two groups, the A group, 61 eyes that underwent 20-gauge standard vitrectomy, and the B group, 60 eyes that underwent 25-gauge vitrectomy. Outcome measures included visual acuity, refractive power, and changes in corneal topography after surgery. Data were analyzed with chi-square test, independent samples t test, one-way ANOVA and Mann-Whitney test. Results The visual acuity of the B group was much better than that of the A group at one week and one month after surgery (x2=8.81, P=0.012; x2=65, P=0.036). The postoperative refractive error in the A group developed into hyperopia, then gradually returned to baseline at three months after surgery. The spherical and astigmatism powers for each timepoint were significantly different in the A group (F=530.12, P＜0.05, F=392.06, P＜0.05), but no significant difference was found in the B group. In the A group, changes of spherical power at 1 week, 4 weeks, 12 weeks after surgery were (+1.93±0.07)D, (+1.06±0.04)D, (+0.15±0.03)D, and changes of astigmatism power were (1.62±0.07)D, (1.05±0.05)D, (0.41±0.03)D. In the B group, changes of spherical power at 1 week, 4 weeks, 12 weeks after surgery were (-0.06±0.02)D, (-0.04±0.03)D, (-0.03±0.02)D, and changes of astigmatism power were (0.05±0.01)D, (0.03±0.01)D, (0.03±0.02)D. Change of spherical power between the A and B groups at 1 week, 4 weeks, 12 weeks after surgery was significant different (t=200.6, 159.3, 26.0, P＜0.01 for all), as well as astigmatism power (t= 173.4, 156.3, 82.3, P＜0.01 for all). At one week after surgery, corneal topography analysis showed that corneal SimK1-K2, surface asymmetry index (SAI), and surface regularity index (SRI) were significantly different compared to baseline (F=4.21, 3.44, 3.28, P＜0.05 for all). However, the changes in comeal topography before and after surgery in the B group were still statistically insignificant. The changes of SimK1-K2, SAI, SRI in A group were significantly more than that in B group (U=51.5, 45.5, 47.0, P＜0.05 for all). Conclusion Compare to a 20-gauge vitrectomy system, a 25-gauge transconjunctival sutureless vitrectomy system provides a more stable refractive status and better improvement in visual function postoperatively in vitreoretinal surgeries.
