Preliminary Study of the Application of 3D Heads-Up Technique in Vitrectomy Combined with Cataract Surgery
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目的： 比较3D平视技术与显微镜目镜下行玻璃体切割联合白内障手术的疗效和安全性。 方法： 回顾性系列病例研究。收集2018年9月至2021年6月于徐州市第一人民医院眼科行玻璃体切割联合白内障手术的患者48例（48眼）的临床资料。根据手术时观察系统不同分为3D平视技术组和显微镜目镜组，每组24例（24眼）。比较2组患者术眼手术持续时间及术中并发症等情况。术后随访3个月，评估术眼手术前后最佳矫正视力（BCVA）、术后解剖复位率和术后并发症发生率情况。数据采用t检验、卡方检验及Fisher确切概率法进行分析。 结果： 显微镜目镜组、3D平视技术组的手术时间依次为（64.4±19.8）min和（63.1±18.5）min，差异无统计学意义（t=-0.27，P=0.089）。术后1、3个月，显微镜目镜组和3D平视技术组术眼BCVA均较术前明显提高，且术后3个月BCVA均优于术后1个月，差异均有统计学意义（P<0.05）。术后1、3个月复查时，同一时间点2组BCVA比较差异均无统计学意义。2组术中出血率、后囊膜破裂率、气体注入率和硅油注入率及术后出现角膜水肿、前房反应、高眼压及低眼压率差异均无统计学意义。随访3个月时显微镜目镜组和3D平视技术组均未出现术后并发症。 结论： 3D平视技术下的玻璃体切割联合白内障手术可以达到与显微镜目镜下同样的治疗效果，且安全性好，可在临床上进行推广。 Objective: To compare the efficacy and safety of 3D heads-up technique and microscope eyepiece in vitrectomy combined with cataract surgery. Methods: This was a retrospective case series study. The clinical data of 48 cases (48 eyes) who underwent vitrectomy combined with cataract surgery in the Department of Ophthalmology in Xuzhou First People's Hospital from September 2018 to June 2021 were selected. According to the surgical observation system, they were divided into 3D heads-up technology group and microscope eyepiece group, with 24 cases (24 eyes) in each group. The duration of intraoperative eye surgery and intraoperative complications were compared between the two groups. After 3 months of follow-up, BCVA, postoperative anatomical reset rate and surgical complications occurred before and after surgery were evaluated. Data were analyzed byt-test, Chi-square test and Fisher exact method. Results: The surgery time of the microscope eyepiece group and 3D heads-up technology group was (64.4±19.8) min and (63.1±18.5) min, and the difference was not statistically significant (t=-0.27, P=0.089). In the microscope group and the 3D heads-up technology group, postoperative BCVA was significantly improved 1 month and 3 months after surgery compared with that before surgery, and improvement of BCVA 3 months after surgery was better than that 1 month after surgery, the difference was statistically significant (P<0.05). At 1 and 3 months after surgery, there was no statistically significant difference in postoperative BCVA at the same time point between the two groups. There was no significant difference in the bleeding rate, posterior capsule rupture rate, gas injection rate and silicone oil injection rate, the rates of corneal edema, anterior chamber reaction, high intraocular pressure and low intraocular pressure between the two groups. There were no postoperative complications in the microscope eyepiece group and the 3D heads-up technique group during the 3-month follow-up. Conclusion: Vitrectomy combined with cataract surgery under 3D heads-up technology can achieve the same therapeutic effect as under microscope eyepieces, with good safety, and can be promoted clinically.
Objective: To compare the efficacy and safety of 3D heads-up technique and microscope eyepiece in vitrectomy combined with cataract surgery. Methods: This was a retrospective case series study. The clinical data of 48 cases (48 eyes) who underwent vitrectomy combined with cataract surgery in the Department of Ophthalmology in Xuzhou First People's Hospital from September 2018 to June 2021 were selected. According to the surgical observation system, they were divided into 3D heads-up technology group and microscope eyepiece group, with 24 cases (24 eyes) in each group. The duration of intraoperative eye surgery and intraoperative complications were compared between the two groups. After 3 months of follow-up, BCVA, postoperative anatomical reset rate and surgical complications occurred before and after surgery were evaluated. Data were analyzed byt-test, Chi-square test and Fisher exact method. Results: The surgery time of the microscope eyepiece group and 3D heads-up technology group was (64.4±19.8) min and (63.1±18.5) min, and the difference was not statistically significant (t=-0.27, P=0.089). In the microscope group and the 3D heads-up technology group, postoperative BCVA was significantly improved 1 month and 3 months after surgery compared with that before surgery, and improvement of BCVA 3 months after surgery was better than that 1 month after surgery, the difference was statistically significant (P<0.05). At 1 and 3 months after surgery, there was no statistically significant difference in postoperative BCVA at the same time point between the two groups. There was no significant difference in the bleeding rate, posterior capsule rupture rate, gas injection rate and silicone oil injection rate, the rates of corneal edema, anterior chamber reaction, high intraocular pressure and low intraocular pressure between the two groups. There were no postoperative complications in the microscope eyepiece group and the 3D heads-up technique group during the 3-month follow-up. Conclusion: Vitrectomy combined with cataract surgery under 3D heads-up technology can achieve the same therapeutic effect as under microscope eyepieces, with good safety, and can be promoted clinically.
3D heads-up techniquevitrectomy surgerycataract surgery
樊芳芳、杨潇、许腾予、李婕、李美丽、王新婷、侯文文、杨柳、李甦雁、吴飞盈
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徐州医科大学附属徐州市立医院眼科 徐州市第一人民医院眼科 徐州市眼病防治研究所，徐州 221116
3D平视技术 玻璃体切割手术 白内障手术
徐州市卫生杰出人才项目徐州市社会发展重点专项项目Xuzhou Health Outstanding Talent ProjectXuzhou Social Development Key Special Project
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