Surgical induced astigmatism correlated with corneal pachymetry and intraocular pressure: transconjunctival sutureless 23-gauge versus 20-gauge sutured vitrectomy in diabetes mellitus

• 作者: Bo-Jie Hu Hui Liu Ju-Ping Liu Li-Jie Dong Xiao-Rong Li Yan Shao Yan Zhang
• 来源期刊: 国际眼科杂志：英文版
• 学科: 医学
• 关键词: ASTIGMATISM cornealpachymetry VITRECTOMY INTRAOCULAR pressure diabetes mellitus
• 年，卷（期）: 2015,（3）
• 页码范围: 528-533
• 页数: 6页
• 分类号: R779.6

摘要

AIM: To determine the difference of surgical induced astigmatism between conventional 20-gauge sutured vitrectomy and 23-gauge transconjunctival sutureless vitrectomy, and the influence of corneal pachymetry and intraocular pressure(IOP) on surgical induced astigmatism in diabetic patients.METHODS: This retrospective, consecutive case series consisted of 40 eyes of 38 diabetic subjects who underwent either 20-gauge or 23-gauge vitrectomy. The corneal curvature and thickness were measured with Scheimpflug imaging before surgery and 1wk; 1, 3mo after surgery. We compared the surgical induced astigmatism(SIA) on the true net power in 23-gauge group with that in 20-gauge group. We determined the correlation between corneal thickness change ratio, IOP and SIA measured by Pentacam. RESULTS: The mean SIAs were 1.082 ±0.085 D( mean ± SEM), 0.689 ±0.070 D and 0.459 ±0.063 D at postoperative 1wk; 1, 3mo respectively in diabetic subjects. The vitrectomy induced astigmatisms were declined significantly with time(F2,36=33.629, P =0.000)postoperatively. The 23-gauge surgery group induced significantly less astigmatism than 20-gauge surgery group(F1,37=11.046, P =0.020). Corneal thickness in diabetes elevated after surgery(F3,78=10.532, P =0.000).The linear regression analysis at postoperatively 1wk went as: SIA =-4.519 +4.931 change ratio(Port3) +0.026IOP(R2=0.46, P =0.000), whereas the rate of cornealthickness change and IOP showed no correlation with the change of astigmatism at postoperatively 1 and 3mo.CONCLUSION: There are significant serial changes in both 20-gauge and 23-gauge group in diabetic subjects.23-gauge induce less astigmatism than 20-gauge and become stable more rapidly than 20-gauge. The elevation of corneal thickness and IOP was associated with increased astigmatim at the early postoperative stage both in 23-gauge and 20-gauge surgery group.