超高速双气动玻璃体切割探针的临床性能比较:更快更小更好吗?

Korean journal of ophthalmology : KJO Pub Date : 2024-04-01 Epub Date: 2024-02-14 DOI:10.3341/kjo.2023.0109
Donghyeon Lee, Sooyeon Lee, Kyung Seek Choi
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摘要

目的:目前市场上使用的玻璃体切割探针种类繁多,而且人们一直在努力开发切割率更高和规格更小的探针。本研究旨在比较各种市售小口径超高速双气动玻璃体切割探针的效率和安全性:我们回顾性分析了顺天乡大学首尔医院特发性视网膜外膜(ERM)患者的病历,并记录了他们接受微切口三孔玻璃体切割手术时的术中视频。根据手术中使用的玻璃体切割探针将患者分为四组:23 号(G)每分钟 7,500 刀的 UltraVit®(23-7500)、25 号(G)每分钟 7,500 刀的 UltraVit®(25-7500)、25 号(G)每分钟 10,000 刀的高级 UltraVit®(25-10K)和 27 号(G)每分钟 10,000 刀的高级 UltraVit®(27-10K):共有 83 只眼睛(83 名患者)参与了这项研究,23-7500、25-7500、25-10K 和 27-10K 组分别有 17、11、26 和 29 只眼睛。各组相应的玻璃体切割时间分别为 295±53.55s、293.09±50.28s、299.92±59.42s 和 349.38±67.23s。各组的玻璃体切割时间有明显差异。(p=0.004).23-7500、25-7500、25-10K 和 27-10K 组的缝合次数分别为 3.00、3.00、2.96 和 0.83。在 23-7500 组中,有一例先天性视网膜破损,而在 27-10K 组中,有一例术后下坠:结论:虽然 27G 玻璃体切割探针的技术有所进步,但与使用 23G 和 25G 探头相比,仍需要更多的玻璃体切割时间。不过,平均延迟时间不超过 1 分钟,而且考虑到缝合的需要大大减少,术后不适感也大大减少。因此,在为 ERM 手术选择四种探头时,根据外科医生的偏好选择 27G 探头是合理的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical Performance Comparison of Ultrahigh-speed Dual Pneumatic Vitrectomy Probes: Is Faster and Smaller Better?

Purpose: Various vitrectomy probes are currently being used commercially, and there are ongoing efforts toward developing probes with higher cutting rates and smaller gauges. This study aimed to compare the efficiency and safety of various commercially available small gauge ultrahigh-speed dual pneumatic vitrectomy probes.

Methods: We retrospectively analyzed the medical records of patients and recorded intraoperative videos while they underwent microincision three-port vitrectomy surgery for idiopathic epiretinal membrane at Soonchunhyang University Seoul Hospital. The patients were categorized into four groups based on the vitrectomy probe used during surgery: 23-7500 (UltraVit 23-gauge 7,500 cuts per minute [CPM]), 23-7500 (UltraVit 25-gauge 7,500 CPM), 25-10K (Advanced UltraVit 25-gauge 10,000 CPM), and 27-10K (Advanced UltraVit 27-gauge 10,000 CPM).

Results: In total, 82 eyes from 82 patients were included in this work, with 16, 11, 26, and 29 eyes in groups 23-7500, 25-7500, 25-10K, and 27-10K, respectively. The corresponding vitrectomy times were 295.56 ± 53.55, 293.09 ± 50.28, 299.92 ± 59.42, and 349.38 ± 67.23 seconds, respectively. There was a significant difference in the vitrectomy time between the groups (p = 0.004). The mean number of sutures was 3, 3, 2.96, and 0.83, respectively. In the 23-7500 group, there was one case of iatrogenic retinal break, while in the 27-10K group, there was one case of postoperative hypotony.

Conclusions: Although advancements have been made in the 27-gauge vitrectomy probe, it still takes more vitrectomy time than it does when using the 23- and 25-gauge probes. However, the delay was within an average of 1 minute, and considering the significantly reduced need for sutures, there is a substantial benefit in terms of postoperative discomfort. Therefore, when choosing a probe for epiretinal membrane surgery among the four options, it is reasonable to select the 27-gauge probe according to the surgeon's preference.

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