| Objective Due to different factors,some cells fiber hyperplasia have formed on the surface of the cell membrane in the retina.it can occur in any part of the retina,the membrane near the macula,so it called epiretinal membranes.Idiopathic epiretinal membranes occurred in the patients with no other eye diseases.Now there is no effective drug treatment for the disease,but pars plana vitrectomy(PPV)can peel the epiretinal membranes.Now 25 G PPV system is relatively common.Along with the advance of technology,27 G PPV system has constantly improved and has been widely used in clinical treatment.Comparing the clinical efficacy of 27 G PPV and 25 G PPV on idiopathic epiretinal membrane(IMEM)can help doctors to make a choice for 25 G or 27 G PPV.Methods Retrospective and comparative case study.Clinical examination diagnosis of 38 patients with 38 eyes of IMEM.Under the condition of patients was informed choice of 27 G or 25 G vitrectomy,18 cases of 18 eyes were treated with 27 G PPV respectively,and 20 cases of 20 eyes were treated with 25 G PPV.Best corrected visual acuity(BCVA),intraocular pressure,slit lamp microscope,indirect ophthalmoscope,fundus color photography,optical coherence tomography(OCT),corneal endothelial cells(CEC)counting,CEC hexagon rate pentacam corneal topography and check.BCVA conversion for minimum resolution Angle of logarithmic(log MAR)vision.Two sets of eyes BCVA preoperatively,intraocular pressure,concave retinal thickness macular center(FMT),the density of CEC and hexagon rate comparison,there was no statistically significant difference(P > 0.05),two groups of patients before surgery corneal thickness of each position there was no statistically significant difference in comparison.With 25 G or accept all 27 G PPV,leading by the same physician to complete.After surgery and record the following indicators:1.Record vitreous cut in the operation time and stripping time and total time;2.Record 1 day after surgery,7 days,1 month,3 months BCVA results;3.Record 1 day after surgery,7 days,1 month,3 months intraocular pressure results;4.7 days after surgery patients,1 month,3 months OCT examination,record all time points FML value;5.3 months after the operation line of CEC count check,record all time points in patients with CEC density and CEC hexagon deformation rate;6.Surgerypatients after 1 day,7 days,1 month,3 months pentacam corneal topographic map to check,record all time points in the postoperative corneal Port1,Port2,Port3,corneal thickness of Port4 position;7.Calculate the 27 g scores and 25 g scores corneal source astigmatism(SIA);8.Depending on the record after surgery in patients with visual quality and deformation to improve the situation.Results 1.Two groups of eye average vitreous cut time,difference was statistically significant(t = 3.084,P < 0.05).2.1 day,7 days,1 month and 3 months after surgery,,two groups of eye log MAR BCVA between comparison,there were no statistically significant difference(P>0.05);3.The two groups had eyes average intraocular pressure comparison,there were no statistically significant difference(P>0.05).4.7 days 1 month and 3 months after surgery,27 G scores and 25 G scores of eye compared the average value of FMT,there were no statistically significant difference(P > 0.05);5.3 months after the surgery,27 G scores and 25 G scores of eye CEC density is,the 5.difference was statistically significant(t = 2.276,P < 0.05);CEC hexagon rate comparison,there was no statistically significant difference(P>0.05).6.Two groups of patients after surgery,1 day,7 days,1 month and 3 months corneal thickness in Port1Port2 Port3 Port4 position there was no statistically significant difference compared the two groups(P>0.05).7.Two groups of patients after surgery,1 week,1 month and 3 months of the cornea is SIA,there was no statistically significant difference period(P < 0.05).8.Two groups of patients in postoperative 1 day,7 days,1 month and 3 months depending on the consciousness of deformation.there was no statistically significant difference period.Conclusion The efficacy of 27-G PPV for IMEM appear similar to 25-G PPV.We found a shorter operating time for vitrectomy,a more stable IOP and a less damage of corneal endothelial cells.27 G and 25 G PPV postoperative 1 month eye refractive conditions consistent with the postoperative 3 months.The patients with refractive errors can be refractive correctionafter 1 month postoperatively. |
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