玻璃体切除术治疗外伤性黄斑孔的疗效分析

A clinical study of vitrectomy for traumatic macular hole

目的对玻璃体切除术治疗外伤性黄斑孑L的疗效进行回顾性分析。方法回顾性分析2000年至2008年期间接受玻璃体切除治疗的外伤性黄斑孑L病例共95例95只眼。均接受标准的扁平部玻璃体切割、气体填充联合或不联合内界膜（ILM）剥除及血小板封孔术。比较手术前后孔的闭合情况及视力的恢复情况。结果术前平均病程为（9．8±21．8）个月，平均孔径为（644．2±270．5）μm，平均最佳矫正视力（BCYA）为0．12±0．1（1．1±0．45）logMAR。术后平均随访（96±131）d，患者视力提高69只眼（72．6％）、不变19只it0．（20％）、下降7只眼（7．4％）。术后BCVA平均为0．22±0．19（0．83±0．40）logMAR，比术前显著提高。术后BCVA达0．2以上者46只眼（48．4％）。单次手术后孔闭合率为100％。结论玻璃体切除术治疗外伤性黄斑孔能有效促进裂孔闭合，提高视力。

Objective To evaluate the outcomes of vitrectomy for traumatic macular hole. Methods The design of this study was retrospective. The participants included 95 eyes of 95 patients who had vitreous surgery for traumatic macular holes during 2000 and 2005. All of them had undergone pars plana vitrectomy, with or without internal limiting membrane peeling, using of concentrated plate and intraocular gas tamponade. The main outcome parameters were preoperative and best visual acuity during follow-up and macular hole closure rate. Results The average course of disease was 9.8± 21.8 months,the average diameter of macular hole was 644.2p m± 270.5μm,the average preoperative best corrected visual acuity （BCVA） was 0.12±0.1 （1.1± 0.451ogMAR）. The average of follow-up after vitrectomy was 96± 131 days. Postoperative BCVA improved in 69 eyes （72.6%）, kept stable in 19 eyes （20%）, decreased in 7 eyes （7.4%）. The average postoperative BCVA was 0.22± 0.19 （0.83±0.401ogMAR） and significantly increased comparing to preoperative BCVA, 46 eyes （48.4%） got postoperative BCVA better than 0.2. Macular hole closure rate after the first surgery was 100%. Conclusions Macular hole surgery results in satisfying anatomical and visual improvements in traumatic macular hole.