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目的评估应用25G经结膜无缝合玻璃体切割手术系统(TSV205G)治疗黄斑裂孔的疗效及手术实用性。方法回顾分析14例14眼行TSV25G玻璃体切割手术治疗的黄斑裂孔患者的临床资料。14例患者术前均未发生视网膜脱离,其中特发性黄班裂孔8例,外伤性黄斑裂孔4例,高度近视性黄斑裂孔2例。对以上患者应用TSV25G系统行玻璃体切除、剥离黄斑前膜和(或)内界膜、气液交换和15%全氟丙烷(C3F8)眼内填充等治疗。手术后随访1.5m~10m,平均4.2m,主要观察黄斑裂孔闭合情况、术后视力、术中及术后并发症。结果所有手术均在(30~50)分钟顺利完成。14例患者中9眼黄斑裂孔闭合,2眼直径缩小,2眼无变化,1眼出现黄斑裂孔性视网膜脱离。术后视力较术前提高者10眼,不变者2眼,下降者2眼。手术并发症主要为穿刺口漏气导致结膜下气肿及眼压偏低,需要补充注射气体以恢复眼压,此外未观察到其它并发症。结论TSV25G应用于黄斑裂孔的手术治疗具有手术时间短、创伤小、术后恢复快等优点,值得推广。
Objective To evaluate the curative effect and operative utility of 25G trans-conjunctival vitrectomy (TSV205G) for the treatment of macular hole. Methods The clinical data of 14 patients with macular hole treated by TSV25G vitrectomy were retrospectively analyzed. None of the 14 patients had retinal detachment preoperatively. Among them, 8 cases were idiopathic yellow banding, 4 cases were traumatic macular hole and 2 cases were high myopic macular hole. The above patients with TSV25G line vitrectomy, stripping the anterior membrane and (or) the endocardial membrane, gas exchange and 15% perfluorinated propane (C3F8) intraocular filling treatment. After the operation, the patients were followed up for 1.5m ~ 10m with an average of 4.2m. Observe the occlusion of macular hole, postoperative visual acuity, intraoperative and postoperative complications. Results All operations were completed successfully (30 ~ 50) minutes. Of the 14 patients, 9 had macular holes closed, 2 had a reduced diameter, 2 had no change, and 1 had macular hole retinal detachment. Postoperative visual acuity increased 10 preoperatively, unchanged in 2 eyes, decreased in 2 eyes. Surgical complications mainly caused by punctured airway leakage caused by subconjunctival emphysema and low intraocular pressure, the need to add gas injection to restore intraocular pressure, in addition to no other complications were observed. Conclusion TSV25G used in the treatment of macular hole surgery has the advantages of short operative time, small trauma, quick recovery, etc., worth promoting.