目的：对比25G和27G玻璃体切割术(PPV)联合无菌空气填充治疗孔源性视网膜脱离(RRD)的临床疗效和安全性。

方法：回顾性分析2016-05/2018-06在我院行PPV联合空气填充治疗的RRD患者63例63眼，其中25G组33例33眼，27G组30例30眼。对比分析两组术前和术后BCVA(LogMAR)、眼压、手术时间、视网膜复位率及并发症发生情况。

结果：两组术前的基线资料均无差异(P>0.05)。25G组与27G组末次随访的BCVA均较术前改善(均P<0.01)，但两组间视力改善幅度无差异(P>0.05)。25G组和27G组的平均手术时间分别为44.13±5.9、46.07±6.1min(t=0.028，P=0.412)。25G和27G组视网膜复位率分别为91%、93%(χ²=0.015，P=0.902)。25G和27G组术后发生一过性低眼压(<6mmHg)的分别为5眼(15%)和3眼(10%)(χ²=0.376，P=0.540)。两组均未观察到脉络膜脱离、感染性眼内炎等严重并发症。

结论：27G PPV联合空气填充治疗RRD在手术时间、视网膜复位率、视力改善及并发症方面与25G无差异，是治疗RRD安全、经济而有效的手术方式。

METHODS: Sixty-three cases(63 eyes)with RRD underwent 27G or 25G PPV from May 2016 to June 2018 were retrospectively reviewed. Thirty-three eyes(33 eyes)for 25G vitrectomy and 30 eyes underwent 27G vitrectomy. The main outcome measurements of the study included the best corrected visual acuity(BCVA, LogMAR), intraocular pressure, surgicaltime, retinal reattachment rate, intraoperative and postoperative complications.

RESULTS: There were no significant differences in baseline demographic between the two groups(P>0.05). The BCVA was increased significantly in both groups(all P<0.01), but there was no significant difference in terms of visual improvement between the two groups(P>0.05). The mean surgical time in the 25G group was(44.13±5.9)min, which was no significant difference than that of 27G group(46.07±6.1)min(t=0.028, P=0.412). The retinal reattachment rate after a single operation was 91% and 93% for 25G and 27G group respectively(χ²=0.015, P=0.902). There was no significant difference about hypotony(<6mmHg, 1mmHg=0.133kPa)between the 25G group(15%)and the 27G group(10%),(χ²=0.376, P=0.540). No serious complication such as choroidal detachment and endophthalmitis was observed in both groups.

CONCLUSION: This study finds no significant differences in the surgical time, the rate of reattachment of retina, improvement of BCVA and complications between the 25G or 27G vitrectomy for rhegmatogenous retinal detachment with air tamponade. 27G vitrectomy with air tamponade seems to be a safe, economical and effective surgery for RRD.