| Objectives:A prospective clinical study on vitreoretinal diseases was held to comparatively evaluate the characteristics of 23-gauge transconjunctival sutureless vitrectomy (TSV 23G)and conventional 20-gauge vitrectomy (20G-PPV), for selecting surgical procedures for doctors to provide theoretical basis.Methods:Continuous collection of a group of sequential rhegmatogenoue retinal detachment (RRD) cases, patients were randomly chosen to underwent 23-gauge transconjunctival sutureless vitrectomy (23G group) or conventional 20-gauge vitrectomy (20G group) by one surgeon. Main measures included visual activity(VA), intraocular pressure(IOP), corneal curvature, surgical time, postoperative anterior segment inflammation reaction, tear film stability and patients'comfort, the healing process of sclerotomies, and related complications.Results:1. Visual acuity(VA):VA increased significantly (P<0.01) in both 23G group and 20G group eventually while no significant intergroup difference except the 7th day and the 15th day postoperatively (P>0.05).2. Intraocular pressure(IOP):There were 3 cases in 23G group and 1 case in 20G group with IOP<9mmHg separately on the postoperative 1st day.4 cases in 20G group with IOP>21mmHg. No significant intergroup difference between preoperative and postoperative (P>0.05).3. Operation time:There were no significant difference for operation time between 23G group and 20G group (P>0.05).4. Corneal curvature:Significant differences had been observed in the 1st and 4th week in 20G group, which was in the 1st week in 23G group compared to preoperation (P<0.05).5. Anterior segment inflammation reaction:Postoperative inflammation reactions (including conjunctival congestion, aqueous flare, inflammation cells and corneal edema) were more severe in 20G group than which in 23G group.6. Tear film stability:There were significant intergroup differences (P<0.05) for CFS, BUT and SIT in early after surgery.7. Patients'comfort:Patients had sensations of foreign body, dryness of eye and dacryorrhea, which were more severe in 20G group than in 23G group. There were no significant difference for ophthalmalgia, ocular itching and discharge of eye between the two groups (P>0.05)8. Sclerotomy related complications:There were no significant intergroup difference (P>0.05) for vitreous incarceration and proliferation in growth between 23G group and 20G group.9. Postoperative complications:Postoperative complications in both groups included temporary hypotension and hypertension were observed. Incision leakage was observed in 1 case in 23G group. one second retinal detachment occurred in 20G group. There was no second retinal detachment in 23G group. No endophthalmitis was observed in both 20G and 23G group.Conclusion:Rhegmatogenoue retinal detachment (RRD) can be effective treated by whether 23-gauge transconjunctival sutureless vitrectomy or conventional 20-gauge vitrectomy (20G group).23G transconjunctival sutureless vitrectomy has characteristics of smaller incision, quicker healing, lighter inflammation reaction, less complications and more comfort. There is risk of endophthalmitis in 23G transconjunctival sutureless vitrectomy because of incision leakage cause by self-closing. |
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