摘要
目的 探讨超高度近视患者行后巩膜加固术后眼底形态的变化。方法 选取2016年5月至2017年8月南昌市第一医院眼科医院收治的行后巩膜加固术的超高度近视患者11例21眼作为研究对象。术后随访24~39个月,检测并记录患者最佳矫正视力(BCVA)、眼轴长度、视盘面积、Bruch膜孔面积、γ区长度、中心凹距视盘颞侧边缘距离、视网膜厚度、脉络膜厚度以及近视性视网膜病变(血管旁病变、视网膜劈裂)情况等。结果 21眼术后末次随访BCVA(logMAR)为4.2~5.0(4.78±0.26),与术前比较差异无统计学意义(P>0.05);末次随访眼轴长度为27.24~33.64(30.49±2.39)mm,与术前相比,术后眼轴增长(0.38±0.34)mm(P<0.05)。21眼术前及术后末次随访视盘面积分别为(2.99±0.96)mm^(2)、(2.84±1.12)mm^(2)(P>0.05),Bruch膜孔面积分别为(7.79±6.65)mm^(2)、(8.12±6.76)mm^(2)(P>0.05),γ区长度分别为(1.39±0.64)mm、(1.31±0.71)mm(P>0.05),中心凹距视盘颞侧边缘距离分别为(4.59±0.74)mm、(4.57±0.64)mm(P>0.05)。与术前相比,术后末次随访21眼ETDRS各区域后极部视网膜厚度和脉络膜厚度变化差异均无统计学意义(均为P>0.05)。术后末次随访,21眼中16眼视网膜结构稳定或近视性视网膜病变减轻甚至消失,5眼出现新的近视性视网膜病变或原有病变加重。结论 超高度近视眼行后巩膜加固术后眼轴仍有增长,眼底形态维持稳定,手术能在一定程度上减轻球内牵拉力。
Objective To evaluate morphologic changes in fundus after the posterior scleral reinforcement(PSR)for super high myopia.Methods Eleven patients(21 eyes)with super high myopia admitted to the Eye Hospital affiliated to the First Hospital of Nanchang City for PSR from May 2016 to August 2017 were included in this study.Postoperative follow-up ranged from^(2)4 to 39 months.The best corrected visual acuity(BCVA),axial length(AL),optic disc(OD)area,Bruch membrane opening(BMO)area,the length of gamma zone,the distance from the fovea to the temporal side of the OD,retinal thickness,choroid thickness,and myopia-associated retinopathy(paravascular lesions and retinoschisis)were measured and recorded.Results BCVA(logMAR)at the last follow-up ranged from 4.2 to 5.0(4.78±0.26 on average),which had no significant difference compared with the preoperative BCVA(P>0.05).AL at the last follow-up ranged from^(2)7.24 to 33.64 mm[(30.49±2.39)mm on average],increasing(0.38±0.34)mm postoperative(P<0.05).Before surgery and at the last follow-up postoperative,the average OD area was(2.99±0.96)mm^(2) and(2.84±1.12)mm^(2),respectively;the average BMO area was(7.79±6.65)mm^(2) and(8.12±6.76)mm^(2),respectively;the average length of gamma zone was(1.39±0.64)mm and(1.31±0.71)mm,respectively;the distance from the fovea to the temporal side of the OD was(4.59±0.74)mm and(4.57±0.64)mm,respectively(all P>0.05).No significant difference was found in the retinal thickness and the choroid thickness in each region of the ETDRS at the last follow-up(all P>0.05).The retinal structure kept stable,or the myopia-associated retinopathy was alleviated or disappeared in 16 eyes,and new myopia-associated retinopathy occurred,or existing lesions aggravated in 5 eyes at the last follow-up.Conclusion After PSR,AL increases in patients with super high myopia,and fundus morphology keeps stable,which indicates the surgery may reduce intraocular traction.
作者
刘维锋
刘莉莉
朱璇
刘毅琦
兰雪莉
闵亚兰
黄国富
LIU Weifeng;LIU Lili;ZHU Xuan;LIU Yiqi;LAN Xueli;MIN Yalan;HUANG Guofu(Nanchang Eye Hospital,the First Hospital of Nanchang City,Nanchang 330000,Jiangxi Province,China;Eye Hospital,Nanchang University,Nanchang 330000,Jiangxi Province,China;Department of Ophthalmology,the Second Affiliated Hospital,Nanchang University,Nanchang 330000,Jiangxi Province,China)
出处
《眼科新进展》
CAS
北大核心
2023年第7期558-561,共4页
Recent Advances in Ophthalmology
基金
江西省科技厅重点项目(编号:20171BBG70100)。
关键词
超高度近视
眼底形态
后巩膜加固术
眼轴长度
super high myopia
fundus morphology
posterior scleral reinforcement
axial length
