Comparative evaluation of the safety of the lens and the ora serrata during vitrectomy with scleral incisions at 5.0 mm or 4.0 mm posterior to the limbus

Q4 Medicine

中华眼底病杂志 Pub Date : 2019-11-25 DOI:10.3760/CMA.J.ISSN.1005-1015.2019.06.005

Xiao Ying, Fang Chen, Wei Du, Jun Zhu, Jun Tong, Chunlan Gan, Xi Chen, Zhenggao Xie

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Abstract

Objective To investigate the lens and ora serrata safety during 23G vitrectomy with sclera incisions at 5.0 mm or 4.0 mm posterior to the limbus. Methods A prospective case-controlled study was adopted. From April 2016 to January 2018, 290 consecutive primary 23G vitrectomy patients (300 eyes) with vitreoretinal disease in Department of Ophthalmology of Subei People’s Hospital Affiliated to Yangzhou University were enrolled in this study. Among them, 146 patients (150 eyes) received 23G pars plana vitrectomy (PPV) with scleral incisions at 5.0 mm posterior to the limbus (5.0 mm group), and 144 patients(150 eyes) at 4.0 mm (4.0 mm group). No statistically significant difference was found in age, axial length(t=−1.324, 0.867; P=0.186, 0.387) and in gender, right/left eyes, proportion of indications (χ2=1.366, 2.615, 10.195; P=0.242, 0.106, 0.070) between the two groups. The incidence rate of complications between the two groups were comparatively observed, such as lens injury, retinal tears close to the scleral incision, retinal hemorrhage, supra-choroidal expulsive hemorrhage and iatrogenic retinal detachment. Independent sample t test and χ2 test were performed for comparison between the two groups. Results Lens injury was observed in 4 eyes(2.67%) and 14 eyes (9.33%) respectively in the 5.0 mm and 4.0 mm group during surgery (χ2=5.910, P=0.015). Retinal tears close to the scleral incision sites were observed in 5 eyes (3.33%) and 6 eyes (4.00%) respectively in the 5.0 mm and 4.0 mm group during surgery (χ2=0.094, P=0.759). The mean time of removing the vitreous base was 6.17±2.76 min and 10.03±5.56 min respectively in the 5.0 mm and 4.0 mm group (t=7.599, P <0.01). No other surgical complications occurred in any group, such as retinal hemorrhage, supra-choroidal expulsive hemorrhage and iatrogenic retinal detachment, etc. Conclusion In primary 23G PPV, the safety of ora serrata with incisions at 5.0 mm posterior to limbus is similar to that at 4.0 mm, but the safety of lens and the efficiency of vitreous resection is higher with incisions at 5.0 mm. Key words: Vitrectomy; Lens, crystalline/injuries; Retinal perforations

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巩膜切口距角膜缘后5.0 mm或4.0 mm玻璃体切除术中晶状体与锯齿眼的安全性比较

目的探讨角膜缘后5.0mm或4.0mm巩膜切口23G玻璃体切割术中晶状体和锯齿环的安全性。方法采用前瞻性病例对照研究。自2016年4月至2018年1月，扬州大学附属苏北人民医院眼科连续290例（300眼）原发性23G玻璃体切除术合并玻璃体视网膜疾病的患者被纳入本研究。其中，146名患者（150眼）接受了23G平坦部玻璃体切除术（PPV），巩膜切口位于角膜缘后5.0mm处（5.0mm组），144名患者（150眼）接受4.0mm处（4.0mm组）。两组在年龄、眼轴长度（t=-1.3240.867；P=0.186,0.387）和性别、右眼/左眼、适应症比例（χ2=1.366,2.615110.195；P=0.242,0.106,0.070）方面无统计学差异。比较观察两组并发症的发生率，如晶状体损伤、巩膜切口附近视网膜撕裂、视网膜出血、脉络膜上排出出血和医源性视网膜脱离。采用独立样本t检验和χ2检验对两组患者进行比较。结果5.0mm组和4.0mm组术中分别有4眼（2.67%）和14眼（9.33%）发生晶状体损伤（χ2=5.910，P=0.015），5.0mm组有5眼（3.33%），4.0mm组有6眼（4.00%）发生巩膜切口附近视网膜撕裂（χ2=0.094，P=0.079）5.0mm组和4.0mm组分别为10.03±5.56min（t=7.599，P<0.01）。任何一组均未发生其他手术并发症，如视网膜出血、脉络膜上渗出出血和医源性视网膜脱离等，但5.0mm切口的晶状体安全性和玻璃体切除效率较高。关键词：玻璃体切除术；晶状体、晶体/损伤；视网膜穿孔

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来源期刊

中华眼底病杂志 Medicine-Ophthalmology

CiteScore

0.40

自引率

0.00%

发文量

5383

期刊介绍： Chinese Journal of Ocular Fundus Diseases is the only scientific journal in my country that focuses on reporting fundus diseases. Its purpose is to combine clinical and basic research, and to give equal importance to improvement and popularization. It comprehensively reflects the leading clinical and basic research results of fundus disease disciplines in my country; cultivates professional talents in fundus disease, promotes the development of fundus disease disciplines in my country; and promotes academic exchanges on fundus disease at home and abroad. The coverage includes clinical and basic research results of posterior segment diseases such as retina, uveal tract, vitreous body, visual pathway, and internal eye diseases related to systemic diseases. The readers are medical workers and researchers related to clinical and basic research of fundus diseases. According to the journal retrieval report of the Chinese Institute of Scientific and Technological Information, the comprehensive ranking impact factor and total citation frequency of the Chinese Journal of Ocular Fundus Diseases have been among the best in the disciplines of ophthalmology, otolaryngology, and ophthalmology in my country for many years. The papers published have been included in many important databases at home and abroad, such as Scopus, Peking University Core, and China Science Citation Database (CSCD).