黄斑内界膜剥离联合超声乳化术治疗特发性黄斑裂孔

Internal limiting membrane peeling combined with phacoemulsification for idiopathic macular holes

目的评价玻切联合超声乳化人工晶体植入术治疗伴有白内障的特发性黄斑裂孔的临床疗效。方法伴有中度以上白内障的特发性黄斑裂孔患者42例(52眼),采用透明角膜切口超声乳化术,标准三切口经睫状体扁平部玻璃体切割术联合黄斑内界膜剥离,植入人工晶体,气/液交换,20%C2F6填充。结果术后52眼经OCT检查证实黄斑裂孔已完全闭合51眼(闭合率为98%),46眼(88.5%)最佳矫正视力较术前提高,术后早期并发症角膜水肿5眼,黄斑区视网膜水肿3眼,眼压升高8眼,随气体吸收眼压恢复正常。随访期间3例出现后发性白内障,行d:YAG激光治疗后视力恢复,其余患者IOL位正,裂孔闭合良好,视力稳定。结论对伴有白内障的特发性黄斑裂孔行黄斑内界膜剥离联合超声乳化人工晶体植入术,操作安全,临床效果好,无长期并发症。

Objective To evaluate the clinical efficacy of vitrectomy and internal limiting membrane peeling combined with phacoemulsification and IOL（Intraocular Lens Implantation） implantation for idiopathic macular holes with cataract. Methods 52 eyes were treated with phacoemulsification and vitrectomy. The internal limiting membrane was peeled and IOL was implanted. The eyes were filled with 20%C2F6 tamponade. Results The closure of the macular hole was confirmed by OCT（Optical coherence tomography） in 51 eyes. Postoperative visual acuity of 46 eyes（88.5%） was improved. Early postoperative complications included corneal edema（5 eyes）,macularedema（3 eyes） and transient increase of IOP （Intraocular pressure,8 eyes）. Late postoperative complications included secondary cataract in 3 eyes,which needed to be treated by Nd：YAG laser. Conclusion As for idiopathic macular holes with cataract,vitrectomy and internal limiting membrane peeling combined with phacoemulsification is a secure,effective method with fewer postoperative complications.