| Objective:To observe the effect of 25 G minimally invasive vitrectomy in the treatment of complex proliferative diabetic retinopathy under the wide Angle microscope with a ChandelierMethods : 30 patients(30 eyes)diagnosed with PDR who visited the ophthalmology department of our hospital from September 2016 to December 2018 were continuously collected.Basic information such as age,gender and course of disease were collected.According to surgical methods,the patients were divided into25 G minimally invasive vitreous surgery group(25G group)and 20 G conventional vitreous surgery group(20G group).The operative time,iatrogenic perforation rate,frequency of electrocoagulation,good corrected visual acuity,intraocular pressure,anterior ganglia inflammation,corneal endothelial count and comfort level were compared between the 25 G group and the 20 G group.Results:The best corrected visual acuity in the 25 G group was 0.45±0.21 1 day after surgery,0.38±0.23 1 month after surgery,and 0.35±0.17 3 months after surgery.The best corrected visual acuity in the 20 G group was 0.60 0.16 1 day after surgery,0.56 0.20 1 month after surgery,and 0.51 0.18 3 months after surgery.The difference between the two groups was statistically significant(P < 0.05).The intraocular pressure of the 25 G group was 16.68±5.79,13.82±5.68,14.38±4.76 on the first day,1 month,and 3 months after surgery,respectively.The intraocular pressure of the 20 G group was15.97±6.17,15.01±5.74,and 14.69±5.23 on the first day,1 month,and 3 months after surgery,respectively.There was no significant difference in intraocular pressure before and after surgery between the two groups(P > 0.05).On the first day after surgery,intraocular pressure was detected.Two patients in the 25 G surgery group had high intraocular pressure,and the range of intraocular pressure was 21-30 mmhg.There were3 cases of high intraocular pressure in the 20 G surgery group,among which 2 cases had intraocular pressure in the range of 21-30 mmhg and 1 case had intraocular pressure in the range of 21-40 mmhg.There was 1 patient with low intraocular pressure in group 25 and no patient with low intraocular pressure in group 20.After corresponding treatment,intraocular pressure of the two groups returned to normal within 7 days after surgery.The operative time of the 25 G group was(52.37 ±16.65)min,and that of the 20 G group was(68.54 ±21.42)min,which was statistically significant(P < 0.05).Electrocoagulation was used in 2 cases in the 25 G group,accounting for 11%,and in 7cases in the 20 G group,accounting for 53%,showing a significant difference.Iatrogenic retinal tear occurred in 1 patient in the 25 G group(5%),and in 5 patients in the 20 G group(38%),the difference was statistically significant(P < 0.05).There was no significant difference in postoperative corneal endothelial count between the two groups(P > 0.05).Postoperative conjunctival edema,corneal edema,anterior chamber sparkle and anterior chamber inflammatory cells in the 20 G group were all heavier than those in the 25 G group(P < 0.05).The difference in comfort level between the 25 G group 1 day and 1 week after surgery was significant(P ﹤0.05),but not at 1 month after surgery(P > 0.05).Conclusion:1.Both 25 G vitrectomy and traditional 20 G vitrectomy can safely and effectively treat proliferative diabetic retinopathy.2.The operation time of 25 G vitrectomy under the wide Angle microscope with the suspended ceiling lamp is short,and the use of electrocoagulation is reduced and the incidence of related complications is reduced,which is more suitable for complex proliferative diabetic retinopathy... |
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