摘要
目的观察板层黄斑裂孔相关视网膜前增生膜（LHEP）联合自体血覆盖治疗退行型板层黄斑裂孔（LMH）的疗效。方法回顾性病例分析。临床检查确诊的LMH患眼28例28只眼纳入研究。其中，男例2例2只眼，女性26例26只眼；均为单眼。均行最佳矫正视力（BCVA）、医学验光、裂隙灯显微镜、间接检眼镜、频域光相干断层扫描、B型超声检查和眼轴长度（AL）测量。BCVA记录时换算为最小分辨角对数（log MAR）视力。28只眼中，退行型裂孔10只眼，占35.7%；均合并LHEP。牵拉型裂孔18只眼，占64.3%；均未合并LHEP。两组患眼logMAR BCVA、AL、中间视网膜水平裂孔直径、晶状体状态比较，差异均无统计学意义（P＞0.05）；内界膜（ILM）水平裂孔直径比较，差异有统计学意义（P＜0.05）；中心凹厚度（CFT）、椭圆体带完整性比较，差异有统计学意义（P＜0.05）。根据手术方法分别将退行型、牵拉型裂孔患眼分为膜填塞组、常规组。膜填塞组患眼常规玻璃体切割手术（PPV）后不行ILM剥除，保留裂孔缘LHEP并填塞于裂孔处；气液交换后通过笛针注入自体全血覆盖于黄斑表面；气液交换后玻璃体腔注入C3F8。常规组患眼常规PPV后气液交换玻璃体腔注入C3F8。手术后随访3～14个月，观察两组患眼CFT、中心凹形态及logMAR BCVA改变。结果末次随访时，膜填塞组、常规组患眼logMAR BCVA分别为0.34±0.27、0.31±0.29；与手术前logMAR BCVA比较，差异均有统计学意义（Z=？3.519、？4.945，P＜0.001）。膜填塞组、常规组患眼CFT分别为（200.10±58.78）、（226.61±70.49）μm。与手术前CFT比较，常规组患眼差异无统计学意义（Z=？1.455，P=0.146）；膜填塞组患眼差异有统计学意义（Z=？2.798，P=0.005）。膜填塞组10只眼中，中心凹形态恢复9只眼，占90.0%；中心凹形态改善 1只眼，占10.0%。常规组18只眼中，中心凹形�
ObjectiveTo observe the efficacy of lamellar？hole-associated？epiretinal？proliferation （LHEP） flap insertion and autologous blood for degenerative type lamellar macular hole （LMH）.MethodsRetrospective case review. Twenty-eight eyes of 28 patients with LMH were enrolled in this study. There were 2 males （2 eyes） and 26 females （26 eyes）. Best corrected visual acuity （BCVA）, medical optometry, slit-lamp biomicroscop, indirect ophthalmoscope, spectral domain optical coherence tomography, b-scan ultrasonography and axial length detection were performed on all patients. Logarithm of the minimum angle of resolution （logMAR） was used to calculate visual acuity. There were 10 eyes （35.7%） with degenerative type LMH （flap insertion group） and LHEP. There were 18 eyes （64.3%） with tractional type LMH （general group）. The differences of BCVA, AL, horizontal hole diameter from retina and lens state between two groups were not significant （P＞0.05）. The differences of horizontal hole diameter of internal limiting membrane （ILM）, central foveal thickness （CFT） and integrity of ellipsoidal zone between two groups were significant （P＜0.05）. LHEP flap insertion and autologous blood without ILM peeling were used in eyes of flap insertion group. Vitrectomy combined ILM peeling were used in eyes of general group. The follow-up was ranged from 3 to 14 months. The changes of CFT, central foveal form and logMAR BCVA were observed.ResultsAt latest follow-up, the BCVA of flap insertion group and general group were 0.34±0.27, 0.31±0.29; which significantly better than the preoperative BCVA （Z=？3.519, ？4.945; P＜0.001）. The CFT of flap insertion group and general group were （200.10±58.78）, （226.61±70.49） μm. There was no difference between pre- and post-operative CFT in eyes of general group （Z=？1.455, P=0.146）. There was significant difference between pre- and post-operative CFT in eyes of flap insertion group （Z=？2.798, P=0.005）. In flap ins
出处
《中华眼底病杂志》
CSCD
北大核心
2017年第6期616-620,共5页
Chinese Journal of Ocular Fundus Diseases
