摘要
目的探讨玻璃体切除联合黄斑前膜剥除术治疗特发性黄斑前膜（IMEM）的疗效。方法回顾性研究。对2000年1月至2015年7月在北京协和医院眼科行玻璃体切除联合黄斑前膜剥除术治疗IMEM的患者51例（51只眼）的临床资料进行回顾性分析。所有患眼治疗前后均进行最佳矫正视力、眼压、裂隙灯前节检查、眼底及OCT检查。黄斑前膜均经手术成功剥除，术后随访时间3～18个月，平均（5．8±3．2）个月。患者手术前后各指标的比较用配对t检验，视力与黄斑厚度的相关关系采用Pearson相关检验。结果51只眼的平均最佳矫正视力由术前4．25±0．34提高至术后4．65±0．23，差异有统计学意义（t=9．012，P=0．000）。51只患眼平均黄斑厚度由术前（432．7±91．7）μm降低到术后（333．3μm±66．1）μm，与治疗前黄斑平均厚度比较，差异有统计学意义（t=10．565，P=0．000）。术前视力与黄斑厚度呈明显负相关（r=-0．452，P=0．001），而术后视力与斑厚度相关性更加明显（r=0．602，P=0．000），术后视力提高行数和黄斑厚度下降程度呈正相关（r=0．382，P=0．006）。12只眼在玻璃体切除术后3—6个月白内障进展，视力下降明显，均给予白内障超声乳化吸除人工晶体植入术，术后视力均有显著提高。结论玻璃体切除术联合黄斑前膜剥除术可以提高患者视力，减轻黄斑水肿，
Objective To investigate the result of vitrectomy with epiretinal membrane （ERM） peeling for idiopathic maeular epiretinal membrane （IMEM）. Methods Clinical data of 51 patients （51 eyes） of IMEM who underwent vitrectomy with ERM peeling were retrospectively investigated. All the pats were examined by visual acuity, slit lamp, fundus under mydriasis, optical coherence tomography （OCT） before and after the surgery. The 3-18 months follow-up were included, mean （5.8±3.2） months. All the macular ERM were removed successfully. Paired-sample t test was used to study the visual acuity and macular foveal thickness before and after surgery. The Pearson correlation analysis was used to study the correlation between visual acuity and macular foveal thickness. Results In the 51 patients, the best visual acuity improved from 4.25±0.34 to 4.65±0.23 postoperatively. The difference was statistically significant （t=-9.012, P=0.000）, and the mean foveomaeular thickness decreased from （432.7 ± 91.7） to （333.3± 66.1）p^m postoperatively, the difference was statistically significant （t=10.565, P=0.000）. There was negative correlation between visual acuity and mean foveomacular thickness （r=- 0.452, P=0.001）, and it was obvious postoperatively（r=-0.602, P=0.000）. The increase of visual acuity was strongly correlated with the decline of mean foveomacular thickness （r=0.382, P=0.006）. Twelve eyes have developed cataract in 3 to 6 months after vitrectomy which affect the visual acuity. All of them went phaeoemulsifieation and intraoeular lenses（IOL） implantation and visual acuity after surgery had an obviously improvement. Conclusions Vitrectomy with ERM peeling can improve visual acuity and ease macular edema. And it is a safe and effective therapy to treat patients of IMEM.
出处
《中华眼科杂志》
CAS
CSCD
北大核心
2016年第5期343-347,共5页
Chinese Journal of Ophthalmology
关键词
视网膜前膜
玻璃体切除术
视力
黄斑
体层摄影术
光学相干
epiretinal membrane
gitrectomy
Visual acuity
Macula lutea
Tomography,Optical Coherence
