黄斑裂孔手术

Operation of macular hole

目的：评价转移生长因子（ＴＧＦｂ）、自体血清、或无眼内填充物治疗黄斑裂孔的手术成功率。 方法对４４例５０只眼行玻璃体切割手术联合后部玻璃体脱离治疗黄斑裂孔。１５只眼术中用ＴＧＦｂ，其中包括 ３ 只眼初次手术失败，２０只眼用自体血清，１５只眼术中无任何填充物。 结果５０只眼中３５只眼（７０％）黄斑裂孔手术成功，其中 ＴＧＦｂ组 １５只眼（１００％），自体血清组１１只眼（５５％），无填充物组 ９只眼（６０％）手术成功（Ｐ＜０．０５）。 ＴＧＦｂ组术后视力均提高（Ｐ＜０． ０５）。术后并发症包括晶体核硬化 （１１只眼， ２２％），视网膜脱离（２ 只眼，４％），眼压高于 ４． ００ｋＰａ并持续１ｗｋ以上（７ 只眼， １４％），自体血清组有 １例术后１ｗｋ发生感染性眼内支。 结论ＴＧＦｂ对治疗黄斑裂孔有显著作用。

Objectives: To evaluate the relative success rate of macular hole (MH) surgery by using either transforming growth factor beta (TGFb ), autologous serum or no adjunct. Methods A retrospective analysis of 44 consecutive patients (50 eyes) who underwent pars plana vitrectomy with detachment of posterior conical hyaloid for the treatment of MH was conducted. TGFb was used in 15 eyes which included 3 eyes with previously failed closure,autologous serum was used in 20 eyes,and no adjunct was used in 15 eyes. Results MH was anatomically closed in 35 (70%)of the 50 eyes. MH closure was found in 15 (100% )eyes in the TGFb group, in 11 (55%) eyes in the autologous serum group, and in 9 (60% ) eyes in the no adjunct group (P< 0. 05). Final visual acuity wes also better in the TGFb group (P<0. 05). Postoperative complications include nuclear sclerosis cataract in 11 (22% )eyes .retinal detachment in 2 (4 % )eyes and increased intraocular pressure of greater than 4. 0kPa for over one week in 7 (14%)eyes. One eye with the treatment of autologous serum developed an infectious endophthahmitis one week after the surgery. Conclusion TGFb can produce a good curative effect on macular hole (MH).