The Comparison Of The Treatment Results Between 20G And 23G Vitrectomy System In Macular Hole

Objective:To compare effect of 23G and 20G vitrectomy system in idiopathic macular hole.Methods:Retrospective observational case series.Retrospective analysis of forty patients(40 eyes)who would undergo virtectomy were involved in this research, including 20 patients(20 eyes)who undergo 20-Gauge vitrectomy while the others 20 patients(20eyes)undergo 23-Gauge vitrectomy in the Department of Ophthalmology, Affiliated Hospital of Medical College, Qingdao University. Observe and compare visual activity(VA), intraocular pressure(IOP), surgical time,breaking up time(BUT), dry eyes symptom score (DES), Schirmer test(ST),corneal fluorescein staining (CFS),postoperative inflammation reaction, corneal endothelial cells,and patients comfort. Ultrasound biomicroscopy(UBM)was used to evaluate related complications of sclerotomy after one month.Results:VA increased significantly (P<0.01) in both 23G group and 20G group eventually,but no significant intergroup difference in two group except the 7th day and the 15th day postoperatively (P>0.05). Intraocular pressure(IOP) is similar between preoperative and postoperative (P>0.05).Compared with patients who underwent 23G vitrectomy,20G patients got more serious DES and CFS, shorter BUT, more secretion of tears at the 3RD,7th,15thday postoperatively(P<0.05). Postoperative inflammation reaction were more severe in 20G group than which in 23G group. Sensations of foreign body, dryness of eye and dacryorrhea were more severe in 20G group than in 23G groupat the 3RD,7th,15thday. 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). And there were no significant difference for operation time and the macular hole closing rates between 23G group and 20G group (P>0.05). vitreous incarceration and proliferation in growth of two group are similar to each other(p>0.05).Conclusion:Compared with conventional 20G vitrectomy,23G transconjunctival vitrectomy doesn't need conjunctival peritomy,sclerotomy suturing and conjunctiva suturing, so could minimizing surgical trauma,alleviating postoperative inflammation, making patient feel more comfortable and getting less serious symptom of dry eye.