扩大的内界膜剥离手术治疗高度近视伴后葡萄肿的黄斑白孔性视网膜脱离

Effect of vitrectomy with largely internal limiting membrane peeling to treat primary retinal detachment due to white macular hole in highly myopic eyes with posterior scleral staphyloma

目的探讨扩大的内界膜剥离手术治疗高度近视伴后葡萄肿的黄斑白孔性视网膜脱离的效果。方法在玻璃体切除手术中采用扩大的内界膜剥离手术（即剥离范嗣达到后葡萄肿边缘）治疗30只眼高度近视伴后葡萄肿的黄斑白孔性视网膜脱离的患者，其中12只眼（40％）注C3F8，18只眼（60％）注硅油。结果27只眼（90％）视网膜复位，3只眼（10％）经再次手术后复位（P〈0．05）；视力改善16只眼（53．4％），不变10只眼（33.3％），下降4只眼（133％）（P〉0．05）。结论扩大的内界膜剥离手术呵有效复位高度近视伴后葡萄肿的黄斑白孔性视网膜脱离，但视力提高无显著性差异。

Objective To evaluate the clinical effects of vitrectomy with largly internal limiting membrane peeling to treat primary retinal detachment due to white macular hole in highly myopic eyes with posterior scleral staphyloma. Methods Thirty highly myopic eyes with posterior scleral smphyloma with primary retinal detachment caused by white macular hole were conducted vitrectomy. During surgery, internal limiting membrane was peeled largely from macular hole to the edge of posterior scleral staphyloma and C3F8 or silicone oil was injected intravitreously in 12 （40%）and 18 （60%）eyes, respectively. Results The retina was reattached in 27 eyes （ 90% ）after the first operation in 3 eyes （ 10% ）after the reoperation （P 〈0.05）. Visual acuity improved in 16 eyes （53.4%）, remained unchanged in 10 eyes （33.3%）, and decreased in 4 （ 13.3% ）after operation（P〉0.05 ）. Conclusions Vitrectomy with largely internal limiting membrane peeling can effectively reattach the retina due to white macular hole in highly myopic eyes with posterior scleral staphyloma without improving the visual acuity significantly.