Dergiler / Retina-Vitreus / 2010 / Cilt: 18 - Sayı: 2
The anatomical and functional outcomes and intraoperative complications of 20 gauge vs 23 gauge pars plana vitrectomy combined with phacoemulsification following intravitreal bevacizumab in diabetic tractional retinal detachment
- Dergi
- Retina-Vitreus
- Sayfa
- 122–128
- DOI
- —
Özet
Amaç: Traksiyonel retina dekolmanı (trd) bulunan proliferatif diyabetik retinopatili olgularda intravitreal bevacizumab (IVB) enjeksiyonunu takiben yapılan fakoemulsifikasyonla kombine 20-gauge pars plana vitrektomi (20G PPV) ile 23-gauge mikroinsizyonel PPV’de anatomik ve fonksiyonel sonuçları ve intraoperatif komplikasyonları karşılaştırmak. Gereç ve Yöntem: 20G (26 göz, Grup A) ve 23G vitrektomi sistemi (23 göz, Grup B) ile ameliyat edilen 43 hastanın 49 gözü retrospektif olarak incelendi. Tüm hastalara ameliyattan 5 gün önce IVB enjeksiyonu yapıldı. Altı aylık takip sonunda fonksiyonel ve anatomik başarı oranları; intraoperatif kanama, iyatrojenik retinal yırtık oranları istatistiksel olarak karşılaştırıldı. Bulgular: Her 2 grupta da ameliyat öncesine göre görme keskinliğinde (GK) anlamlı artış tespit edildi (p 0,05). Sonuç: Diyabetik trd olgularında, 20G PPV ve 23G mikroinsizyonel PPV ile benzer görsel ve anatomik sonuçlar elde edilmesine rağmen 23G sistemi ile daha az intraoperatif kanama görülmektedir. Buna göre diyabetik trd olgularında IVB enjeksiyonunu takiben yapılan 23G mikroinsizyonel PPV, cerrah açısından daha avantajlı görünmektedir.
Abstract
Purpose: To compare the anatomical and functional results and intraoperative complications between 20 gauge pars plana vitrectomies (20 G PPV) and 23 gauge microincisional PPV’s combined with phacoemulsification surgery following an intravitreal bevacizumab (IVB) injection for proliferative diabetic retinopathy with tractional retinal detachment (TRD). Material and Methods: 49 eyes of 43 patients who underwent PPV using 20 G system (26 cases, Group A) and 23 G system (23 cases, Group B) were analysed retrospectively. All patients received an injection of IVB 5 days before surgery. Intraoperative bleeding, iatrogenic retinal tears, the functional and anatomical success rate with at least 6 months follow-up were compared statistically between the groups. Results: Significant improvement in visual acuity (VA) was obtained in both groups (p<0.05). No statistically significant difference was found between the two groups in terms of mean preoperative and postoperative VA’s, mean change in VA and the number of cases with improvement and regression in VA. The anatomical success rate did not differ between the groups. Intraoperative bleeding occurred in 12/26 cases in Group A and 3/23 in Group B (p=0.03). There was no significant difference between the groups in terms of development of intraoperative retinal breaks (p>0.05). Conclusion: It was concluded that the advantages of 20 G PPV and 23 G microincisional PPV were similar in terms of visual and anatomical results for diabetic trd cases, but intraoperative bleeding occurs less frequently with 23 G system. Therefore the 23 G microincisional PPV following administration of IVB in diabetic trd cases would be more advantageous for surgeons.