摘要
目的探讨25G微创玻璃体切除联合完全内界膜剥除与联合保留中心凹处内界膜剥除术治疗高度近视黄斑劈裂的效果比较。方法回顾33例(33只眼)高度近视黄斑劈裂需行玻璃体切除术的病例,分为A组20例(20只眼)完全剥除内界膜,B组13例(13只眼)保留中心凹处内界膜,均行25G玻璃体切除联合C3F8气体填充。术后随访6个月。术前及术后1、3、6个月行最佳矫正视力(BCVA)、眼压、裂隙灯显微镜、间接检眼镜、A型和(或) B型超声、相干光断层扫描(OCT),记录BCVA以及黄斑中心凹厚度(CFT)、视网膜复位情况及手术并发症。结果术后至最后随访期,A组术后1、3、6个月视力较术前提高,差异有统计学意义(P=0. 000,P=0. 000,P=0. 003),B组术后1、3、6个月视力较术前提高,差异有统计学意义(P=0. 010,P=0. 010,P=0. 013),两组间视力差异无统计学意义(F=0. 106,P=0747)。A组术后1、3、6个月CFT较术前降低,差异有统计学意义(P=0. 000,P=0. 000,P=0. 000),B组术后1、3、6个月CFT较术前降低,差异有统计学意(P=0. 000,P=0. 000,P=0. 00),两组间黄斑中心凹视网膜厚度无统计学意义(F=0. 779,P=0. 515)。两组术后视网膜大部分完全复位,劈裂腔消失。其中A组随访期间出现2只眼黄斑裂孔。结论 25G微创玻璃体切除联合内界膜剥除治疗高度近视黄斑劈裂是有效及安全的,保留中心凹处内界膜的剥除术可以降低术中及术后黄斑裂孔的发生率。
Objective Comparison the effect of 25G vitrectomy with internal limiting membrane peeling and with fovea-sparing internal limiting membrane peeling for myopic foveoschisis. Methods Thirty-three eyes of thirty-three patients with myopic foveosehisis underwent vitreoretinal surgery were divided into two groups： group A （20 eyes） were treated with 25G vitrectomy combined with completely ILM peeling, and group B（13 eyes） was treated with 25G vitrectomy combined with fovea-Sparing internal limiting membrane peeling, all of the eyes were treated with 25G vitrectomy combined with C 3F 8 gas intraocular tamponade. The follow-up was 6 months after operation. The best corrected visual acuity（BCVA）,intraocular pressure,slit lamp microscope, indirect ophthalmoscope,A or B ultrasonic scan and optical coherence tomography（OCT） were performed before and after operation. The BCVA, central fovea thickness（CFT） , retinal reattaehment and the complications were observed. Results Postoperative follow-up to the last,in A group , the BCVA were improved at 1 month, 3 months, 6 months, and the difference was statistically significant（ P =0.000, P =0.000, P =0.003）, in B group, the BCVA were improved at 1 month, 3 months, 6 months, and the difference was statistically significant（ P =0.010, P =0.010, P =0.013）, there is no statistically difference between the two groups（ F =0.106, P =0747）. In A group, the CFT were reduced at 1 month,3 months,6 months, and the difference was statistically significant（ P =0.000, P =0.000, P =0.000）,in B group, the CFT were reduced at 1 month, 3 months, 6 months, and the difference was statistically significant（ P =0.000, P =0.000, P =0.00）,there is no statistically difference between the two groups（ F =0.779, P =0.515）. Most of eyes foveoschisis were reattached and split cavity disappeared in most of eyes in both groups. Two eyes in the group A developed macular hole in follow up. Conclusions 25G vitrectomy with ILM peeling is effective and safe for myopic
作者
王艳辉
张胜娟
李云环
李雅琳
李磊磊
王莉菲
Wan Yanhui;Zhang Shengiuan;Li Yunhuan;Li Yalin;Li Leilei;Wang Lifei(Hebei Eye Hospital,Hebei Province Key Ophthalmology Laboratory,Hebei 054700,China)
出处
《临床眼科杂志》
2018年第5期385-389,共5页
Journal of Clinical Ophthalmology
基金
河北省科技计划项目(152771020)
