摘要
目的:探讨23G玻璃体切割术联合曲安奈德玻璃体腔注射(IVTA)治疗特发性黄斑前膜(iERM)的疗效。方法:采用随机对照研究方法,纳入2013年9月至2014年6月在北京同仁医院就诊的iERM患者49例49眼。采用随机数字表法将患者随机分为玻璃体切割术联合IVTA组24例24眼和单纯玻璃体切割术组25例25眼,单纯玻璃体切割术组术眼仅接受23G玻璃体切割术和黄斑前膜剥除术,玻璃体切割术联合IVTA组术眼术中玻璃体腔注射曲安奈德注射液2 mg。分别于术前及术后1、3、12个月测定术眼最佳矫正视力(BCVA),采用非接触眼压计测量术前及术后1、3、12个月眼压,采用光相干断层扫描仪(OCT)检测手术前后术眼黄斑中心厚度(CMT)和黄斑区容积;评估术后1、3和12个月BCVA、CMT和黄斑容积变化量。结果:术后1个月、12个月玻璃体切割术联合IVTA组和单纯玻璃体切割术组术眼BCVA均优于术前,差异均有统计学意义(均P<0.05);术后1个月和12个月玻璃体切割术联合IVTA组术眼CMT值分别为(432.46±66.68)μm和(378.38±42.31)μm,单纯玻璃体切割术组CMT值分别为(433.20±52.71)μm和(383.00±47.58)μm,均低于术前的(487.58±93.84)μm和(517.64±92.05)μm,差异均有统计学意义(均P<0.05)。术后1个月、12个月玻璃体切割术联合IVTA组黄斑容积分别为(11.68±1.11)mm^3、(10.68±0.91)mm^3,单纯玻璃体切割术组黄斑容积分别为(11.66±0.66)mm^3、(10.36±0.57)mm^3,小于术前的(12.86±2.24)mm^3和(13.06±1.42)mm^3,差异均有统计学意义(均P<0.05)。玻璃体切割术联合IVTA组、单纯玻璃体切割术组术后1、3和12个月与术前BCVA、CMT和黄斑容积的变化量比较,差异均无统计学意义(均P>0.05)。玻璃体切割术联合IVTA组术后3眼眼压升高,占12.5%,局部应用降眼压药物后恢复正常。结论:玻璃体切割术联合IVTA治疗iERM是安全、有效的,可改善术眼BCVA、CMT和黄斑容积,但联合IVTA对术后黄斑区功能恢复并无
Objective To study the outcome of intravitreal injection of triamcinolone acetonide(IVTA)as an adjuvant in vitrectomy for idiopathic epiretinal membranes(iERM).Methods A randomized controlled trial was designed.Forty-nine eyes of 49 patients with iERM were included in Beijing Tongren Hospital from September 2013 to June 2014.The patients were randomized into a vitrectomy group(25 eyes)and a vitrectomy combined with IVTA group(24 eyes),and IVTA 2 mg was performed during vitrectomy in the vitrectomy combined with IVTA group.Best corrected visual acuity(BCVA,LogMAR)was examined before and after surgery.Intraocular pressure was measured to evaluate the safety of the surgeries.Optical coherence tomography(OCT)were employed to assess the central macular thickness(CMT)and macular volume.The differential values between postoperative 1 month,3 months,12 months were calculated to quantify the variable quantity of BCVA,CMT and macular volume.The study protocol was approved by an Ethics Committee of Beijing Tongren Hospital.This study complied with the Declaration of Helsinki.Results BCVA in postoperative 1 month and 12 months was better than that in preoperation in the vitrectomy combined with IVTA group(all at P<0.05).In post operative 1 month and 12 months,CMT was(432.46±66.68)μm and(378.38±42.31)μm in the vitrectomy with IVTA group or(433.20±52.71)μm and(383.00±47.58)μm in the vitrectomy group,which was less than(487.58±93.84)and(517.64±92.05)μm in preoperation(all at P<0.05).In post operative 1 month and 12 months,macular volume was(11.68±1.11)mm^3 and(10.68±0.91)mm^3 in the vitrectomy with IVTA group or(11.66±0.66)mm^3,(10.36±0.57)mm^3 in the vitrectomy group,which was less than(12.86±2.24)mm^3 and(13.06±1.42)mm^3 in the preoperation(all at P<0.05).The differential values of BCVA,CMT and macular volume in postoperative 1 month,3 and 12 months from preoperation were not significantly different(all at P>0.05).Postoperative intraocular pressure increased in 3 eyes(12.5%)in the vetrectomy with IVTA group a
作者
刘菊
王怡
高萌
刘丽梅
刘武
Liu Ju;Wang Yi;Gao Meng;Liu Limei;Liu Wu(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Ophthalmology﹠Visual Sciences Key Lab,Beijing 100730,China;Department of Ophthalmology,Beijing Electric Power Hospital,Beijing 100073,China)
出处
《中华实验眼科杂志》
CAS
CSCD
北大核心
2020年第7期609-613,共5页
Chinese Journal Of Experimental Ophthalmology
关键词
特发性黄斑前膜/手术
玻璃体切割术
玻璃体腔注射
曲安奈德
黄斑区
光相干断层扫描
随机对照研究
Idiopathic epiretinal membrane/surgery
Vitrectomy
Intravitreal injection
Triamcinolone acetonide
Macula
Optical coherence tomography
Randomized controlled-clinical trail
