Clinical outcomes of 25-gauge vitrectomy surgery for vitreoretinal diseases: comparison of vitrectomy alone and phaco-vitrectomy

(整期优先)网络出版时间:2016-08-18
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AIM:Tocomparetheclinicaloutcomesofcombined25-gaugeparsplanavitrectomy(PPV)andphacoemulsification/posteriorchamberintraocularlens(PC-IOL)implantationwithvitrectomyalonesurgeryinpatientswithvariousvitreoretinaldiseases.METHODS:Atotalof306eyes(145withPPValoneand161withphaco-vitrectomy)wereenrolledinthisretrospectiveanalysis.Thesurgicalapproachwas25-gaugePPVcombinedwithphacoemulsificationandPC-IOLimplantationatthesametimeineyesinphaco-vitrectomygroupandonlyPPVineyesinvitrectomyalonesurgerygroup.Themainoutcomemeasureswerepostoperativeclinicaloutcomesincludedanteriorchamberinflammation,changesinintraocularpressure(IOP)andbestcorrectedvisualacuity(BCVA).RESULTS:Themostcommonpostoperativecomplicationwasanteriorchamberreactionwhichhashigherincidenceinphaco-vitrectomygroup(P<0.001).Themeanpostoperative1stdayIOPofvitrectomyalonegroupwassignificantlylowerthanthatofphaco-vitrectomygroup(16.3±5.8mmHgvs17.8±8.1mmHg,respectively,P=0.02).Hypotony(IOP(8mmHg)wasnotdifferentbetweengroupsinthepostoperative1stday(P>0.05).Themeanpreoperativevisualacuitywasnotdifferentbetweengroups(1.6±0.9logMARvs1.8±0.9logMAR,respectively,P>0.05).However,themeanvisualacuitywasdecreasedinvitrectomyalonegroupatthefinalvisitcomparedtophaco-vitrectomygroup(1.2±0.8logMAR,0.9±0.7logMAR,respectivelyP<0.05).CONCLUSION:Twenty-fivegaugePPVcombinedwithphacoemulsificationsurgeryisasafeandefficientprocedure,whichcanbepreferredinphacicpatientswithavarietyofvitreoretinaldiseasescomparedtovitrectomyalone.Despiteimprovedoutcomes,thisapproachisnotfreeoflimitationsasanteriorchambercomplicationsespeciallywithcombinedsurgery.