摘要
目的观察大直径特发性黄斑裂孔患者行内界膜填塞术或内界膜翻转覆盖术手术前后黄斑区形态及血流特征变化。方法选取2019年2月至2020年2月在蚌埠医学院第一附属医院收治的大直径(>600μm)特发性黄斑裂孔患者27例(27只眼)进行研究。随机分为A组(玻璃体切除+内界膜填塞+玻璃体腔消毒空气填充术)和B组(玻璃体切除+内界膜翻转覆盖+玻璃体腔消毒空气填充术)行手术治疗,观察两组患者术前、术后1个月、3个月的最佳矫正视力(BCVA)、外界膜(ELM)缺损直径、中心凹无血管区(FAZ)面积变化及裂孔愈合形态。结果两组患者术后BCVA较术前均有明显改善(P<0.05),且翻转覆盖组术后BCVA优于填塞组,术后1个月(t=2.298,P=0.030),术后3个月(t=2.196,P=0.038)。两组患者术后ELM缺损直径均较术前减小(P<0.05),但两组间比较无明显差异,术后1个月(t=0.440,P=0.664),术后3个月(t=1.894,P=0.07)。两组患者术后FAZ面积均较术前减小(P<0.05),但两组间比较无明显差异,术后1个月(t=-0.543,P=0.592),术后3个月(t=-0.376,P=0.710)。结论玻璃体切除联合内界膜填塞术或内界膜翻转覆盖术均是治疗大直径特发性黄斑裂孔有效的手术方式,但是内界膜翻转覆盖术术后视力及裂孔闭合形态优于内界膜填塞术。
Objective To observe the changes in macular structure and blood flow characteristics in patients with large diameter idiopathic macular hole before and after internal limiting membrane(ILM)tamponade or inverted internal limiting membrane flap technique.Methods A total of 27 patients(27 eyes)with large diameter(>600μm)idiopathic macular hole treated in the First Affiliated Hospital of Bengbu Medical College from February 2019 to February 2020 were selected for a prospective case-control study.The patients were randomly divided into two groups:group A(vitrectomy combined with ILM tamponade and vitreous cavity sterilized air tamponade)and group B(vitrectomy combined with inverted ILM flap technique and vitreous cavity sterilized air tamponade).The best corrected visual acuity(BCVA),defect diameter of external limiting membrane(ELM),area of foveal avascular zone(FAZ)and macular hole sturcture were observed before and at 1 month and 3 months after the operation to compared the clinical effect.Results The postoperative BCVA in both groups was significantly better than that before operation,and the postoperative BCVA in the inverted flap group was better than that in the group A at 1 month(t=2.298,P=0.030)and 3 months after the operation(t=2.196,P=0.038).The diameter of ELM defect in both groups were smaller than that before the operation,but there was no significant difference between the two groups(postoperative 1 month:t=0.440,P=0.664;postoperative 3 months:t=1.894,P=0.07).The FAZ area of the two groups decreased after the operation,but there was no significant difference between the two groups(postoperative 1 month:t=-0.543,P=0.592;postoperative 3 months:t=-0.376,P=0.710).Conclusions ILM tamponade technique or ILM flap technique are both stable surgical methods for large diameter idiopathic macular hole,but the visual acuity and macular hole closure morphology after the inverted ILM flap technique are better than the ILM tamponade technique.
作者
王爱芹
高自清
张锐
Wang Aiqin;Gao Ziqing;Zhang Rui(Department of Ophthalmology,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China)
出处
《临床眼科杂志》
2021年第2期111-114,共4页
Journal of Clinical Ophthalmology
关键词
特发性黄斑裂孔
内界膜填塞
内界膜翻转覆盖
黄斑结构
Idiopathic macular hole
Inverted internal limiting membrane flap technique
Internal limiting membrane tamponade technique
Macular structure
