目的：探讨23G和25G+微创玻璃体切割术治疗孔源性视网膜脱离的疗效和安全性。

方法：选择2015-08/2016-08医院眼科收治的孔源性视网膜脱离患者130例130眼作为研究对象，按照随机数字表法将130眼患者分为试验组和对照组，每组各65眼。试验组给予25G+微创玻璃体切割术治疗，对照组给予23G微创玻璃体切割术治疗，比较两组患者手术时间、术中并发症发生率、视网膜复位情况、视力恢复情况、治疗前后眼压、术后并发症。

结果：试验组手术时间为66±12min，对照组手术时间为69±11min，差异无统计学意义(P>0.05)； 试验组发生3眼医源性视网膜裂孔，术中并发症发生率为4.6%，对照组发生5眼医源性视网膜裂孔，术中并发症发生率为7.7%，差异无统计学意义(P>0.05)； 试验组视网膜一次性复位率为96.9%，最终复位率为90.8%，对照组视网膜一次性复位率为93.9%，最终复位率为87.7%，试验组与对照组一次复位率和最终复位率比较，差异无统计学意义(P>0.05)； 术后试验组末次随访LogMAR视力为0.241±0.062，对照组为0.253±0.057，与手术前比较有明显的差异(P<0.05)，组间比较差异无统计学意义(P>0.05)； 试验组和对照组术前、术后眼压相较，差异均无统计学意义(P>0.05)； 试验组术后并发症发生率为44.6%，对照组术后并发症发生率为63.1%，差异有统计学意义(P<0.05)。

结论：25G+微创玻璃体切割术治疗孔源性视网膜脱离安全有效，术中损伤小，术后恢复快，相较于23G玻璃体切割术在降低术后并发症方面有一定的优势。

METHODS: From August 2015 to August 2016, 130 cases of rhegmatogenous retinal detachment patients were chosen as the research object. According to the random number table method, 130 patients were divided into experimental group and control group, 65 cases in each group. The experimental group received 25G+ minimally invasive vitrectomy, the control group was given 23G minimally invasive vitrectomy. The operation time, complication rate, retinal reattachment, visual acuity, intraocular pressure and postoperative complications were compared between the two groups.

RESULTS: The operative time was 69±11min in control group and 66±12min in the experimental group(P>0.05). The experimental group had 3 cases of iatrogenic retinal breaks, intraoperative complication rate was 4.6%, the control group of 5 cases of iatrogenic retinal breaks during the operation, the complication rate was 7.7%(P>0.05). The experimental group disposable retinal reattachment rate was 96.9%, the final reduction rate was 90.8%; the control group disposable retinal reattachment rate was 93.9%, the final reduction rate was 87.7%, those differences between the experimental group and the control group were no significant(P>0.05). At the end of the follow-up visual acuity of experimental group was logMAR 0.241±0.062, control group 0.253±0.057, significantly different compared with before treatment(P<0.05), while not different between the two groups(P>0.05). intraocular pressure of the two groups were not significantly different before and after surgery(P>0.05). The complication rate was 44.6% after operation in the experimental group, the complication rate was 63.1% in control group(P<0.05).

CONCLUSION: The 25G+ minimally invasive vitrectomy in the treatment of rhegmatogenous retinal detachment is safe and effective, less operative trauma, rapid postoperative recovery, less postoperative complications compared with 23G vitrectomy.