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眼内填充洁净空气的玻璃体切除术治疗IV期黄斑裂孔的疗效分析

邵蕾  张慧  卢宁
  

  1. 100730 首都医科大学附属北京同仁医院 北京同仁眼科中心 眼科学与视觉科学北京市重点实验室
  • 收稿日期:2016-12-30 出版日期:2017-11-25 发布日期:2017-12-02
  • 通讯作者: 卢宁,Email:luningnl@aliyun.com E-mail:luningnl@aliyun.com
  • 基金资助:

    首都医科大学附属北京同仁医院科研种子基金(2016-YJJ-ZZL-009)

Efficacy of vitrectomy combined with tamponade of room air on IV stage idiopathic macular hole

SHAO Lei, ZHANG Hui, LU Ning   

  1. Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
  • Received:2016-12-30 Online:2017-11-25 Published:2017-12-02
  • Contact: LU Ning, Email: luningnl@aliyun.com E-mail:luningnl@aliyun.com

摘要:

目的  观察眼内填充洁净空气的玻璃体切除术治疗IV期黄斑裂孔的疗效。设计  回顾性病例系列。研究对象  IV期黄斑裂孔患者10例(10眼)。方法 所有患者行最佳矫正视力(BCVA)、眼压、裂隙灯检查、间接检眼镜、彩色眼底照相、眼部彩色多普勒超声、相干光断层扫描(OCT)检查。行23G经睫状体平坦部三通道微创玻璃体切除术,术中玻璃体填充洁净空气辅助顶压视网膜。术后随访9~107天,平均(28.9±33.4)天。主要指标 BCVA、黄斑裂孔闭合以及手术并发症情况。 结果 末次随访时,10眼中,OCT检查黄斑裂孔完全闭合9眼(90%);部分闭合1眼(10%)。术后末次随访BCVA手动~0.6,平均BCVA(logMAR视力)1.27±0.84;手术前后视力变化-0.3~0.36,较术前平均提高0.26±0.31(t=2.73,P=0.023)。末次随访视力提高者6眼(60%),平均提高0.56±0.26(0.28~1.00);视力下降者1眼(10%),降低0.3;视力稳定者3眼(30%)。结论  此小样本研究结果表明眼内填充洁净空气的玻璃体切除术治疗IV期黄斑裂孔可获得较好疗效。

关键词: 黄斑裂孔, 玻璃体切除术

Abstract:

Objective To evaluate the efficacy of vitrectomy combined with intraocular tamponade of room air on the IV stage idiopathic macular hole. Design Retrospective case series. Participants Ten eyes of 10 patients with IV stage idiopathic macular hole underwent vitreoretinal surgery. Methods All the patients had undergone the examinations of best corrected visual acuity (BCVA),intraocular pressure,slit lamp microscope, indirect ophthalmoscope, ultrasonic scan, fundus photographs and optical coherence tomography (OCT). A standard 3-port pars plana vitrectomy (23-gauge system) was performed in all patients, and fill with room air in the vitreous cavity at the end of the operation to auxiliary press the retina. The follow-up duration varied from 9 to 107 days. Main Outcome Measures The BCVA, retinal reattaehment and the complications. Results At the latest follow-up, 9 eyes(90%) were anatomically reattached, 1 eyes (10%) was partly anatomically reattaehed,no eye was not reattached; postoperative BCVA improved in 6 eyes (60%),unchanged in 3 eyes (30%),and decreased in 1 eyes(10%). Conclusion This small sample study shows that the vitrectomy combined with tamponade of room air can effectively treat IV stage idiopathic macular hole without ocular complications.

Key words: macular hole, vitrectomy