特发性黄斑裂孔玻璃体切除手术联合空气填充的临床观察
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Clinical observation of vitrectomy combined with room air-filled for idiopathic macular hole
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    摘要:

    目的:通过观察空气填充在特发性黄斑裂孔闭合、黄斑形态和功能变化的情况,得出玻璃体术后空气填充是否是特发性黄斑裂孔值得推荐的填充方式。

    方法:采用回顾性分析方法,选择连续手术的特发性黄斑裂孔31例31眼行23G玻璃体切除手术后填充空气,观察患者最佳矫正视力(BCVA)、裂孔闭合、IS/OS破坏直径、手术前后视物变形程度、手术并发症,探讨此类患者玻璃体切除术后空气填充的临床意义及应用价值。

    结果:孔径≤250μm的闭合率是100%,孔径250~400μm的闭合率为88.9%,孔径400~600μm的闭合率为93.3%; 最佳矫正视力在基线和术后1、3mo是0.12±0.08,0.28±0.15和0.27±0.18; 手术前IS/OS破坏直径为1962.1±510.7μm,术后3mo,IS/OS破坏直径为1245.3±396.5μm,手术前后IS/OS破坏直径差异有统计学意义(P=0.016); 术后俯卧位时间为3.5±0.4d; 患者视物变形明显改善; 术后未发生严重并发症。

    结论:该研究表明,对于特发性黄斑孔而言,空气填充能达到较好的裂孔闭合、视功能恢复、俯卧位时间较短且无严重手术并发症。黄斑裂孔玻璃体切除手术后填充空气是一值得推荐的手术方式。

    Abstract:

    AIM: To obtain whether air tamponade is the recommended way after vitrectomy in idiopathic macular hole by surveying the closure rate, functional and morphological recovery after surgery with room air-filled.

    METHODS:A total of 31 eyes of 31 patients with consecutive idiopathic macular hole, who undergone 23-gauge pars plana vitrectomy with room air-filled were retrospectively studied. Surgical outcomes were analyzed, regarding best-corrected visual acuity(BCVA), hole closure rate, damage diameter of IS/OS with spectral domain optical coherence tomography(SD-OCT), the degree of visual distortion before and after surgery, surgical complications to discuss clinical significance and value about the patients after air tamponade.

    RESULTS: The closure rate was 100% among the patients with hole diameter ≤250μm. The closure rate was 88.9% among thoes 250~400μm, and it was 93.3% among those 400~600μm. Mean BCVA at baseline, 1 and 3mo was 0.12±0.08, 0.28±0.15 and 0.27±0.18, respectively. The damage diameter of IS/OS was 1962.1±510.7μm before surgery and 1245.3±396.5μm 3mo after surgery. The differences were statistically significant before and after surgery(P=0.016). The mean prone posturing period was 3.5±0.4d. The degree of visual distortion had significant improvement. There were no serious surgical complications after surgery.

    CONCLUSION: Room air tamponade can obtain good closure rate, recovery of visual function, a short time in the prone position and no serious surgical complications for idiopathic macular hole. It is the recommended surgical approach after vitrectomy in idiopathic macular hole.

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陶明,李艳,张文芳.特发性黄斑裂孔玻璃体切除手术联合空气填充的临床观察.国际眼科杂志, 2015,15(11):2006-2008.

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  • 收稿日期:2015-06-16
  • 最后修改日期:2015-10-20
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  • 在线发布日期: 2015-10-30
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