Objective To observe the relationship between the suturing patterns to close the scleral incision and postoperative intraocular pressure (IOP) in 23G minimally invasive vitrectomy. Methods Eighty eyes of 80 patients with vitreoretinal diseases, who were treated with primary 23G minimally invasive vitrectomy, were enrolled in this prospective clinical study. Patients with poor closed scleral incision which need suturing were excluded from this study. The corrected visual acuity ranged from hand movement to 0.2. The IOP ranged from 7.9 to 19.8 mm Hg (1 mm Hg=0.133 kPa), with the mean of (13.9plusmn;1.8) mm Hg. The eyes were randomly divided into three groups: group A (20 eyes), suturing all three scleral puncture after vitrectomy; group B (20 eyes), suturing only two upper scleral puncture, but not the lower infusion puncture after vitrectomy; group C (40 eyes), no suturing for all 3 scleral puncture after vitrectomy. All patients underwent 23G vitrectomy only. The corrected visual acuity and IOP were observed after surgery. Results The corrected visual acuity were 0.1 -0.3, 0.2- 0.5, 0.3 -0.8 in one, seven and 14 days after surgery, respectively. No one in group A, B experienced hypotony in one, three, seven and 14 days after surgery. Thirteen (32.5%), five (12.5 %), two eyes (5.0%) in group C experienced hypotony in one, three and seven days after surgery. Seven eyes (17.5%) experienced severe hypotony (＜5 mm Hg) in 14 day after surgery in group C. The difference was statistically significant compared the incidence of hypotony in group C with group A, B respectively at different time points after surgery (chi;2= 16.82,P=0.007). The difference was statistically significant compared the incidence of hypotony in group C at different time points after surgery (chi;2=11.64,P=0.003). The difference was no significant compared the IOP between group A and B at different time points after surgery (F=1.618,P=0.205). Compared the IOP of group C to group A and B, the difference was statistically significant in one and three days after vitrectomy (F=9.351,P=0.000); but not statistically significant in seven and 14 days after vitrectomy(F=0.460,P=0.633). Conclusions Whether or not suturing the scleral punctures is closely related to postoperative hypotony in 23G vitrectomy. Suturing only the two upper scleral punctures can reduce the occurrence of postoperative hypotony.
Objective To investigate how many hospitals can perform vitrectomy and its relationship to economic development in China.Methods Bibliometric data of retina-vitreous literatures were searched from the China National Knowledge Infrastructure (CNKI) academic databases. We used pars plana vitrectomy (PPV) as a keyword and defined address as mainland China, limited years to 1993 -2009. From those data we analyzed which hospital performed PPV. We also communicated with some hospitals by phone, email to confirm if they were performing PPV. Gross domestic product (GDP), population data and economic development ranking were extracted from the China Statistical Yearbook 2009 (National Bureau of Statistics of China). PPV carry-out rate, PPV-hospital shares and their relationships with the GDP in each regional municipality were analyzed.Results All together this study retrieved 4632 articles meet our requirements. There were 340 hospitals carrying out PPV in mainland China, located in 22 provinces, five autonomous regions and four metropolitan municipalities. The top five provinces with higher PPV carryout rate were Shandong (93,75%), Zhejiang (90,00%), Hebei province (90.00%), Jiangsu (83.33%) and Guangdong (75.00%). There was significant difference in per capita share of PPVhospitals between different cities (chi;2=181,153，P=0,000) and in the PPV carry-out rate between different cities (chi;2=749.217，P=0.000). There were 210 private eye hospitals in China,62 hospitals (18.23%) of them could perform PPV included 39 hospitals located in regionallevel cities. The coefficient correlation between PPV and GDP of different provinces was 0.842 (P=0.000). Conclusions Vitrectomy is widely performed in mainland China, but geographical distribution of PPV-performing hospitals is uneven. PPV performance is closely related with regional economic development,and private hospitals play certain roles in promoting the application of vitrectomy.