玻璃体黄斑牵引综合征的手术疗效观察

Observations on vitrectomy for vitreomacular traction syndrome

目的 探讨玻璃体手术治疗玻璃体黄斑牵引综合征的临床效果及光相干断层扫描、荧光素眼底造影对手术疗效的评价.方法 经裂隙灯前置镜、间接眼底镜检查、B超、光相干断层扫描（OCT）、荧光素眼底血管造影（FFA）等检查确诊为玻璃体黄斑牵引综合征行玻璃体手术的患者30例（30只眼）的临床资料进行回顾性分析.结果 30只眼经手术解除玻璃体对黄斑部的牵引.术后20只眼视力提高.术后黄斑区牵引处OCT测量高度平均减小267μm,有明显改善.术前荧光素眼底血管造影检查存在黄斑囊样水肿伴渗漏,术后明显减轻.术前合并高度近视眼者视力预后不佳.结论 玻璃体手术能够有效解除玻璃体对黄斑部的牵引,阻止患者视力进一步下降,减轻黄斑水肿及渗漏,是治疗玻璃体黄斑牵引综合征的有效方法.光相干断层扫描及荧光素眼底造影检查可以对手术疗效进行评价,有利于术后随访.

Objective To evaluate the efficacy of vitreous surgery for patients with vitreomacular traction syndrome. Methods Of 30 patients （30 eyes） who underwent vitrectomy for vitreomacular traction syndrome were retrospectively analyzed. Results Vitreomacular traction was released successfully, and a better visual acuity was obtained in 20 eyes. Mean macular thickness decreased by 267μ m postoperatively. The eyes showed statistically significant improvement in visual acuity and central macular thickness （P 〈0.05）. Optical coherence tomography （OCT） and fluorescein fundus angiography （FFA） showed macular edema gradually alleviated after vitreous surgery. Preoperative high myopia was associated with prognosis of postoperative visual acuity （P〈0.05）. Conclusions Vitrectomy can relieve macular traction, and is effective for decreasing macular thickness and improvement of vision in vitreomacular traction syndrome. OCT and FFA are useful for evaluation and follow-up for vitreomacular traction syndrome.