ABSTRACT
AIM:To explore the curative effect of 20G and 25G three-channel pars plana vitrectomy in the treatment of idiopathic macular epiretinal membrane,and to provide a theoretical basis for the minimally invasive treatment of idiopathic macular epiretinal membrane.METHODS:Medical records were retrospectively analyzed to explore curative effect.From January 2014 to December 2016,60 patients (60 eyes) with idiopathic macular pucker in our hospital for eye treatment were selected.They were grouped according to different operation way,in 28 patients (28 eyes) using three-channel 20G pars plana vitrectomy as the control group,32 patients (32 eyes) with 25G no-suture conjunctival vitrectomy as observation group.Two groups of patients were evaluated at 3mo after treatment for visual acuity,OCT examination,comfort,and we recorded the operation time,complications and recurrence.RESULTS:The operating time of observation group was 18-25min,average 20±2.15min,the control group was 22-35min,28 ± 2.07min on average,the difference was statistically significant (P＜0.05).At the time of the last follow-up,visual acuity of two groups improved compared with preoperative,without vision decrease.In observation group vision improved in 69％,significantly higher than that of control group (50％),difference was statistically significant (x2 =7.287,P＜ 0.05).Preoperative intraocular pressure of two groups was not significantly different.intraocular pressure of two group at postoperative 1d reduced compared with preoperative (Ftime =31.34,P＜0.01;Fgr.up =17.43,P＜0.01).There was no statistically significant difference at 7d and 1mo compared with preoperative (P＞0.05).Preoperative OCT on macular thickness of the two groups had no statistically significant difference.At 7d,1 and 3mo after treatment,epiretinal membranes disappeared in all patients,and the macular thickness reduced,the macular edema relieved (P＜ 0.05).At postoperative 3mo,two groups of patients were found no recurrence of epiretinal membranes.At 7d,1 and 3mo after treatment,differences between the two groups on macular thickness had no statistical significance.At postoperative 1d,in the control group there were foreign body sensation,swelling,and tears,pain and discomfort,20 patients with eye conjunctival congestion,edema,conjunctival suture to cause discomfort,the symptoms relieved after treatment.In observation group,12 patients with mild conjunctival congestion and edema,dotted hemorrhage at the wound in 4 eyes,5 eyes appeared lower intraocular pressure (6-8mmHg).without special treatment,Postoperative bleeding and edema stopped at 7d,intraocular pressure returned to normal.Patients of observation group did not have foreign body sensation,swelling and discomfort symptoms.At the time of the last follow-up,in the two groups,no iatrogenic retinal detachment,cataract,endophthalmitis and other serious complications occurred.CONCLUSION:The 20G of three-channel pars plana vitrectomy and 25G the no-suture conjunctival vitrectomy are equal for idiopathic macular epiretinal membrane,25G vitrectomy operation time is short with better patient comfort.