25G玻璃体切割联合扩大内界膜剥离治疗特发性黄斑裂孔

25gauge vitrectomy combined with companded internal limited membrane peeling for idiopathic macular hole

目的观察应用25G玻璃体切割联合扩大内界膜剥离治疗特发性黄斑裂孔的效果。方法经光学相干断层扫描、中心视野、眼底荧光血管造影及眼底照相等检查诊断为特发性黄斑裂孔患者20例20只眼，均接受25G三通道玻璃体切割术，术中在吲哚菁绿的辅助下以25G内界膜镊行扩大内界膜剥离，所有患眼行C3F8气体填充，对手术时间、术后最佳矫正视力、中心视野、黄斑裂孔愈合情况进行观察，随访6-12个月，平均8个月。结果手术时间为12-18min，平均15min；最佳矫正视力：0．1-0．3者2只眼，〉0．3-0．5者8只眼，〉0．5-0．8者10只眼；术后末次中心视野检查发现中心暗点者2只眼，旁中心暗点者为1只眼。OCT检查提示19只眼黄斑裂孔闭合，有1只眼黄斑裂孔缩小，但未完全封闭。结论应用TSV25G系统治疗特发性黄斑裂孔具有较好的治疗效果，能明显提高视力，改善视物变形，缩短手术时间，减少并发症。

Objective To observe the effect of 25gauge vitrectomy combined with companded internal limited membrane peeling for idiopathic macular hole. Methods Twenty cases （20 eyes） with idiopathic macular epiretinal membrane diagnosed by optical coherence tomography, fluorescence fundus angiography, central visual field, fundus photography. All cases underwent three ports vitrectomy using 25gauge Trauscon- junctival Sutureless Vitrectomy System. Cornpanded internal limited membrane peeling was conducted with 25g intraocular forceps with the help of staining of Indocyanine green. All patients were temponaded with C3F8. The operation time, postoperative BCVA, central visual field, the healing of macular hole were ob- served. Follow-up was 6-12 months, meanly 8 months. Results The operation lasted for 12-18minutes, meanly 15 minutes; Among them, the BCVA was 0.1-0.3 in two eye, 〉0.3-0.5 in eight eyes, 〉0.5-0.8 in ten eyes; In all patients, central scotoma occurred in 2 eyes, paracentral scotoma in 1 eye in the last fol- low-up. Macular holes were closed in nineteen eyes, while one macular hole was closed partly. Conclu-sions 25gauge vitrectomy combined with companded internal limited membrane peeling is effective in treat- ment for idiopathic macular hole, it can promote visual acuity, shorten operation time, make metamorphopsia better, decrease complication.