摘要
目的分析玻璃体切除术(PPV)联合内界膜(ILM)翻转覆盖术治疗黄斑孔的效果及影响术后视力的因素。方法回顾性病例对照研究。收集郑州市第二人民医院2021年5月至2022年6月96例(96眼)黄斑孔患者的临床资料进行分析,患者均接受PPV联合ILM翻转覆盖术治疗。根据术前黄斑孔最小水平直径分为A组(≤250μm,35例)、B组(>250~400μm,32例)、C组(>400μm,29例),对比术后1、3及6个月的最佳矫正视力(logMAR,BCVA)、术前眼轴长度、裂孔最小直径、裂孔基底直径、中心凹下脉络膜厚度、病程、性别、年龄、眼别和黄斑区脉络膜萎缩等,采用logistic回归模型分析影响术后BCVA的危险因素。结果96例经PPV联合ILM翻转覆盖术治疗后1个月,所有患眼黄斑孔均闭合。A组术后1、3及6个月的BCVA分别为0.32±0.11、0.24±0.08、0.16±0.05,均明显优于B组的0.47±0.19、0.34±0.13、0.28±0.11和C组的0.82±0.28、0.62±0.23、0.52±0.18,而B组术后1、3及6个月的BCVA,明显优于C组,差异具有统计学意义(均P<0.05)。3个组在黄斑区脉络膜萎缩、术前视力、病程、裂孔最小直径、裂孔基底直径及中心凹下脉络膜厚度比较,差异均具有统计学意义(均P<0.05)。多项logistic回归分析显示,中心凹下脉络膜厚度是影响手术后视力恢复的保护因素(均P<0.05),黄斑区脉络膜萎缩、术前BCVA、病程、裂孔最小直径、裂孔基底直径是影响术后视力恢复的危险因素(均P<0.05)。结论PPV联合ILM翻转覆盖术治疗黄斑孔有利于改善视力。其中,中心凹下脉络膜厚度、黄斑区脉络膜萎缩、术前视力、病程、裂孔最小直径、裂孔基底直径均为影响术后视力恢复的重要因素。
Objective To analyze the efficacy of pars plana vitrectomy(PPV)combined with internal limiting membrane(ILM)inversion in the treatment of macular hole and the factors affecting postoperative visual acuity.Methods This was a retrospective case-control study.Clinical data of 96 eyes of 96 patients with macular hole in Zhengzhou Second People’s Hospital from May 2021 to Jun.2022 were analyzed.All patients received PPV combined with ILM inversion covering.Based on the minimum horizontal diameter of macular hole before operation,they were divided into group A(≤250μm,35 cases),group B(>250-400μm,32 cases),and group C(>400μm,29 cases).Best corrected visual acuity(BCVA,logMAR)at 1,3,and 6 months after surgery were compared with baseline data of axial length,minimum macular hole diameter,hole base diameter,subfoveal choroidal thickness,disease course,gender,age,eye difference and macular choroidal atrophy.Logistic regression model was used to analyze the risk factors affecting postoperative visual acuity.Results At 1 month after PPV combined with ILM inversion covering,the macular hole were closed in all 96 patients.BCVA of group A at 1,3 and 6 months after operation were 0.32±0.11,0.24±0.08 and 0.16±0.05,respectively,which were significantly better than that of group B(0.47±0.19,0.34±0.13,0.28±0.11)and that of group C(0.82±0.28,0.62±0.23,0.52±0.18),BCVA of group B at 1,3 and 6 months after surgery were significantly better than those of group C(all P<0.05).There were statistically significant differences in choroidal atrophy,preoperative visual acuity,course of disease,minimum diameter of hole,diameter of hole base and choroidal thickness under fovea among the 3 groups(all P<0.05).Multiple logistic regression analysis showed that the thickness of choroid under fovea was a protective factor affecting postoperative visual acuity recovery(P<0.05).Choroidal atrophy in macular area,BCVA before surgery,course of disease,minimum hole diameter and hole base diameter were risk factors affecting postoperative visua
作者
潘俊辉
高延庆
孙艳华
杨媛媛
Pan Junhui;Gao Yanqing;Sun Yanhua;Yang Yuanyuan(Department of Ophthalmology,Zhengzhou Municipal Second People's Hospital,Zhengzhou Ophthalmology Research Institute,Zhengzhou 450000,China)
出处
《中华眼外伤职业眼病杂志》
2023年第8期605-611,共7页
Chinese Journal of Ocular Trauma and Occupational Eye Disease
关键词
孔
黄斑
复杂
覆盖术
内界膜
改良
效果
治疗
Hole,macula,complex
Covering,limiting,inner,improve
Efficacy,treatment
