曲安奈德和吲哚青绿双染法辅助下玻璃体切除术治疗特发性黄斑孔

Double visualization using triamcinolone acetonide and indocyanine green during vitrectomy in the treatment of idiopathic macular bole

目的探讨曲安奈德（TA）和吲哚青绿（ICG）双染法辅助下玻璃体切除联合内界膜剥除术治疗特发性黄斑孔的疗效。方法26例（26眼）均行玻璃体切除联合内界膜剥除术，术中应用TA和ICG辨认玻璃体后皮质和内界膜，术毕填充16％C3F8气体。结果随访3—18个月，2例失访，23例黄斑孔完全闭合，1例未闭合者伴近锯齿缘处小裂孔后以硅油填充后闭合。随访患者24例中，21眼视力提高，2眼不变，1眼视力稍下降。结论术中应用TA可以更清晰地辨认玻璃体后皮质，ICG的应用则有助于内界膜的剥除。TA和ICG双染法辅助下玻璃体切除术治疗特发性黄斑孔安全有效。

Objective To evaluate the safety and efficacy of double using triamcinolone acetonide （TA） and indocyanine green（ICG） during vitrectomy with internal limiting membrane （ILM） peeling for id- iopathic maeular hole（IMH）. Methods Pars plana vitrectomy with ILM peeling was performed in 26 eyes of 26 patients. TA and ICG were used respectively to identify posterior vitreous cortex and ILM. Finally, 16% C3 Fs was tamponaded. Results Anatomic closure of the macular hole was achieved in 23 patients, with- drawed in 2 cases and failed in 1 patient with small hole near ora serrata who underwent the surgery with sili- cone oil tamponaded finally. Visual acuity improved in 21 eyes, remained unchanged in 2 eyes, decreased in one eye. Conclusion The injection of TA makes the posterior vitreous cortex visualized clearly in all pa- tients. Upon the injection of ICG,the ILM can be successfully removed in all patients. Double visualization of the posterior vitreous cortex and ILM using TA and ICG during vitrectomy may be safe and effective.