使用經結膜免縫線玻璃體切除系統之初步臨床經驗

Initial Experiences of Using 25-Gauge Transconjunctival Sutureless Vitrectomy System (TSV25) for Vitreoretinal Surgery

張雲翔(Yun-Hsiang Chang) ； 譚清龍(Chen-Lung Tan) ； 江尚宜(Shang-Yi Chiang) ； 張正忠(Cheng-Jong Chang)

《中華民國眼科醫學會雜誌》 42卷1期 (2003/03) Pp. 49-56

https://doi.org/10.30048/ACTASOS.200303.0008

摘要

研究目的：評估經結膜免縫線玻璃體切除系統(TSV25)進行玻璃體視網膜手術之實用性與安全性，並比較其與傳統20號玻璃體切除系統之手術時間與手術後異物感，並描述本院使用此系統之初步臨床經驗。
研究設計：以前瞻性計畫進行一系列病例手術。
實驗組與對照組：二十個病例根據其診斷與嚴重性配對並分為二組，一組以TSV25進行手術，此為實驗組；另一組以傳統20號玻璃體切除系統進行手術，此為對照組。
研究方法：手術時間分為三階段，每一病例的每一階段手術時間經詳細測量及記錄後進行比較。術後並記錄及比較病患自覺之異物感。為評估無縫線切口是否滲漏，實驗組手術前後之眼壓均詳細測量。
研究結果：實驗組之總手術時間明顯比對照組短。實驗組病患術後自覺之異物感亦明顯較對照組輕微。除了一例有青光眼病史的患者外，實驗組患者術後眼壓均在正常範圍內。
結論：TSV25有效簡化了手術步驟，並縮短了手術時間。手術切口無縫線，且均無滲漏狀況，術後異物感大為減輕，加速患者復原。

並列摘要

Purpose: To evaluate the time efficiency of the 25-gauge transconjunctival sutureless vitrectomy system (TSV25) compared with standard 20-gauge instruments. And also to describe the initial experience of using TSV25, to evaluate the safety and feasibility.
Design: Prospective study of a consecutive interventional case series.
Participants and Controls: There were 20 patients divided into 2 groups. Similar cases in diagnosis and severity were matched for comparison. Ten of them underwent vitreoretinal surgeries using the TSV25 served as the study group; the other 10 underwent vitreoretinal surgeries using the existing 20-gauge system served as the control group.
Methods: The operation was divided into 3 portions. The time of each portion of every patient was measured and recorded for comparison. Post-operative foreign body sensation was also evaluated subjectively. Pre- and post-operative intraocular pressures were measured in the study group for evaluating the self-sealing condition of the sutureless wounds.
Results: Mean total operative time was signifycantly shorter for the study group than for the control group. The post-operative foreign body sensation was much less in the study group than in the control group at various post-operative time-points. The postoperative intraocular pressures were all within normal limits except one glaucoma case.
Conclusions: TSV25 indeed simplifies the surgical technique and reduces operative time. Its micro, suturless incisions make good self-sealing, less postoperative foreign body sensation and faster convalescence.

並列關鍵字

Transconjunctival Sutureless Vitrectomy System ； TSV25 ； sutureless ； vitrectomy ； foreign body sensation ； wound leakage ； intraocular pressure