共焦激光断层扫描评价黄斑裂孔手术解剖疗效

Morphological assessment of macular hole surgery by scanning laser tomography

目的 探讨共焦激光断层扫描 (scanning laser tomography,SL T)在评价黄斑裂孔手术疗效中的作用。 方法 采用德国海德堡公司的视网膜断层扫描仪 (Heidelberg retina tomograph,HRT) ,检测14例黄斑裂孔患者 15只患眼黄斑部视网膜地形图参数 ,并对其中 11只眼行玻璃体视网膜手术前后视网膜地形图差异进行分析。 HRT扫描野设置为 15°× 15°,扫描深度范围为 1.5～ 2 .0 mm。每只受检眼探测 3次 ,取 3次图像的均值分析。 结果 HRT定量检测显示 15只眼黄斑裂孔的平均面积为 (0 .4 99± 0 .34)mm2 ,裂孔最大深度为 (0 .2 84± 0 .11) mm。 11只黄斑裂孔眼玻璃体视网膜手术后裂孔周围视网膜高度较手术前明显降低 ,手术后裂孔最大深度为 (0 .0 6 3± 0 .0 4 ) mm。 结论 SL T能探测黄斑裂孔的三维结构 ,并作定量的地形图参数分析 。

Purpose To explore the role of scanning laser tomography in the assessment of macular hole surgery. Methods Fifteen eyes of 14 patients with macular holes underwent scanning of their affected macular area using the Heidelberg retina tomograph (HRT). The significance of topographic changes postoperatively were determined in eleven eyes which received vitrectomy surgery. The scan field was set at 15° of the retina and the depth was set to 1.5 mm or 2.0 mm. All the measurements were taken for 3 times and the average value of the 3 measurements was used. Results The average hole area was (0.499±0.34) mm 2 and the maximal depth of the hole was (0.284±0.11) mm. Topographic difference analysis of the eleven eyes showed a significant reduction in the height of the retina after vitrectomy. The maximal depth of the hole was (0.063±0.04) mm postoperatively. Conclusion Scanning laser tomography provides an objective evaluation of the anatomic outcome of the macular hole surgery.