Objective To compare the clinical efficacy of 23-gauge vitrectomy and conventional 20-gauge vitrectomy for the treatment of vitreous hemorrhage. Methods A total of 15 patients(15 eyes) were treated with 23-gauge vitrectomy (group A) and 20 patients(20 eyes) were treated with conventional 20-gauge vitrectomy(group B). The time for setting up 3 channels, time for closing the wound, best corrected visual acuity, intraocular pressure, postoperative comfortableness of patients, inoperative and postoperative complication and the wound healing of sclerotomy were analyzed. Results Time for setting up 3 channels and time for closing the wound between two groups has statistical difference(t=12.51,13.57, P<0.05). Postoperative visual acuity of patients in both A and B groups were significantly different when compared with before operation (χ2=8.85,10.40, P<0.05). There was no statistical difference between two groups of postoperative visual acuity (χ2=0.22,P>0.05). There was statistical difference of average intraocular pressure of the two groups at first day postopera-tive(t=1.94,P<0.05) while there was no statistical difference of that at third day and seventh day(t=0.45,1.11, P>0.05). Compared with 20-gauge vitrectomy group, the postoperative rational comfortableness and the wound healing of sclerotomy of 23-gauge vitrectomy group were significantly different(χ2=9.94,7.69, P<0.05). During operation, there was neither ia-trogenic retinal hole occurrence nor severe complication happened. There was no vitreous rebleeding and retinal detachment occurred in either group after 3 months following-up. Conclusions Both 23-gauge vitrectomy and 20-gauge vitrectomy can treat simple vitreous hemorrhage effectively. 23-gauge vitrectomy has obvious advantage in terms of time for setting up 3 channels, time for closing the wound and alleviating postoperative sticking of vitre-ous body at sclerotomy wound. The postoperative comfortableness of the patients treated with 23-gauge vitrectomy is also better than those were treated with 20-gauge vitrectomy. The improvement of visual acuity of two methods are similar.%目的：比较微创23G经结膜无缝线玻璃体手术和传统20G玻璃体手术治疗玻璃体积血的临床效果。方法15例（15眼）患者接受微创23G玻璃体手术（A组），20例（20眼）患者接受传统20G玻璃体手术（B组），分析比较这两种手术建立三通道时间、关闭切口时间、术后最佳矫正视力、眼压、术后舒适度、术中术后的并发症及术后巩膜穿刺口的愈合情况等。结果两组建立三通道的时间、关闭切口的时间差异均有统计学意义（t分别=12.51、13.57，P均＜0.05）。 A组和B组术后与术前视力比较均有不同程度的提高，差异有统计学意义（χ2分别=8.85、10.40，P均＜0.05），两组术后视力比较差异无统计学意义（χ2=0.22，P＞0.05）。两组术后1 d的平均眼压比较，差异有统计学意义（t=1.94，P＜0.05），而术后3 d、7 d的平均眼压比较，差异均无统计学意义（t分别=0.45、1.11，P均＞0.05）。术后两组自觉舒适度、巩膜穿刺口愈合情况比较，差异均有统计学意义（χ2分别=9.94、7.69，P＜0.05）。两组术中无1例出现医源孔，均未发生严重并发症。3月后末次随访结果示两组均未发生玻璃体再次出血，未发生视网膜脱离。结论23G和20G玻璃体切割术都能有效治疗玻璃体积血的疾病。微创23G玻璃体手术在建立三通道时间、关闭切口的时间和减轻术后巩膜穿刺口的玻璃体嵌顿上有明显优势，且术后舒适度优于传统20G玻璃体手术，在术后视力提高方面，两组疗效相仿。
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