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使用鲨鱼皮镊与传统镊进行视网膜前膜手术的临床比较

Clinical comparison of epiretinal membrane surgery using Sharkskin forceps versus conventional forceps.

作者信息

Yu Ting, Tao Yong, Zhou Qiang, Hu Xiaofeng, Hua Wen, Xu Zhuozai, Yang Shuo, Chen Li

机构信息

Department of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, No.8, South Road of Worker's Stadium, Chaoyang District, Beijing, 100020, China.

Joint laboratory of Drug Delivery & Innovative Therapy built by Beijing Chaoyang Hospital & State Key Laboratory of Biochemical Engineering, Institute of Process Engineering, Chinese Academy of Sciences, Beijing, China.

出版信息

BMC Ophthalmol. 2025 Jul 1;25(1):348. doi: 10.1186/s12886-025-04206-5.

Abstract

PURPOSE

To evaluate and compare the outcomes between eyes that underwent pars plana vitrectomy (PPV) for epiretinal membrane (ERM) using the Sharkskin forceps versus conventional forceps.

METHODS

The prospective comparative study involved 38 eyes with ERM between November 2022 and May 2023. Nineteen eyes were treated with PPV and membrane peeling using the Grieshaber Sharkskin forceps, while the other 19 eyes were treated with conventional forceps. The number of grasps for initial membrane mobilization, duration for complete membrane peeling, best-corrected visual acuity (BCVA) and central macular thickness (CMT) before PPV and within three-month follow up, adverse events were recorded.

RESULTS

All patients successfully underwent ERM removal. The Sharkskin group completed membrane removal in 198.84 s with 8.21 grasps for initial membrane mobilization, compared to 250.95 s and 10.53 grasps in the conventional group (p = 0.20, p = 0.15). Sharkskin forceps caused significantly fewer retinal dimples (0.58 ± 0.69) compared to conventional forceps (1.26 ± 0.93) (p = 0.02). Postoperative BCVA improved by 21.2% in the Sharkskin group and 29.9% in the conventional group (p = 0.018, p < 0.001); however, there was no significant difference in BCVA improvement between the two groups (p = 0.24). Similarly, CMT decreased by 17.8% in the Sharkskin group and 14.3% in the conventional group (p = 0.006, p = 0.015), with no significant difference in CMT reduction between groups (p = 0.49). No other grasp-related complications or ERM recurrences were observed during the follow-up period.

CONCLUSION

The use of Sharkskin forceps in ERM surgery demonstrated comparable clinical outcomes to conventional forceps, while causing less retinal damage. These findings suggest that Sharkskin forceps can be safely and effectively utilized in vitreoretinal interface surgery.

摘要

目的

评估并比较使用鲨鱼皮镊与传统镊进行玻璃体视网膜前膜(ERM)的扁平部玻璃体切除术(PPV)的手术效果。

方法

这项前瞻性比较研究纳入了2022年11月至2023年5月期间的38例ERM患者的患眼。19只眼采用Grieshaber鲨鱼皮镊行PPV及膜剥除术,另外19只眼采用传统镊进行手术。记录初始膜松动所需的夹持次数、完全剥除膜的持续时间、PPV术前及术后3个月内的最佳矫正视力(BCVA)和中心黄斑厚度(CMT)以及不良事件。

结果

所有患者均成功完成ERM剥除。鲨鱼皮镊组剥除膜用时198.84秒,初始膜松动需夹持8.21次,而传统镊组分别为250.95秒和10.53次(p = 0.20,p = 0.15)。与传统镊(1.26±0.93)相比,鲨鱼皮镊导致的视网膜压痕明显更少(0.58±0.69)(p = 0.02)。鲨鱼皮镊组术后BCVA提高了21.2%,传统镊组提高了29.9%(p = 0.018,p < 0.001);然而,两组间BCVA改善情况无显著差异(p = 0.24)。同样,鲨鱼皮镊组CMT降低了17.8%,传统镊组降低了14.3%(p = 0.006,p = 0.015),两组间CMT降低幅度无显著差异(p = 0.49)。随访期间未观察到其他与夹持相关的并发症或ERM复发。

结论

在ERM手术中使用鲨鱼皮镊与传统镊的临床效果相当,但对视网膜的损伤更小。这些发现表明鲨鱼皮镊可安全有效地用于玻璃体视网膜界面手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92f9/12210765/51ec10f661cc/12886_2025_4206_Fig1_HTML.jpg

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