特发性黄斑前膜术后视功能及黄斑区形态结构的变化

Visual acuity and macular morphous changes of idiopathic macular epiretinal membrane after surgery

目的评估特发性黄斑前膜经23G微创玻璃体切割术后视功能及黄斑区结构的变化。方法回顾性分析了28例(28眼)于我院行23G微创玻璃体切割术+内界膜剥除术+玻璃体注射2mg曲安奈德的黄斑前膜患者临床资料,术前术后行最佳矫正视力、眼压、眼底照相、眼底OCT检查,术后随访半年。结果 25例25眼患者视力提高,3例3眼视力未见提高;最佳矫正视力由术前的0.17±0.10提高至术后的0.37±0.22(P<0.05)。黄斑中心凹厚度也由术前的(498.07±116.95)μm降至术后的(329.46±111.15)μm,差异有统计学意义(t=7.730,P<0.05)。线性相关分析发现术后最佳矫正视力的好坏与术后黄斑中心凹厚度呈明显的线性相关(r=0.413,P=0.029)。大部分患者在随访期内黄斑中心凹黄斑厚度未能降至正常。结论黄斑前膜剥除术可以很好地改善患者的视功能,明显改善黄斑中心凹结构,但是大部分患者黄斑中心凹厚度未能完全恢复正常。

Objective To evaluate the visual acuity and macular morphous changes of idiopathic mcuiar epiretinal membrane after 23G-minimally invasive vitrectomy. Methods A retrospective study of 28 patients （28 eyes） with idiopathic macular epiretinal membrane was conducted. 23G-minimally invasive vitrectomy combined with internal limiting membrane peeling, intravitreal injection of 2 mg triamcinolone were performed. The follow-up time was 6 months. The best corrected visual acuity （ BCVA）, intraocular pressure, fundus photograph, fundus OCT were examined before and after surgery. Results The postoperative visual acuity in 25 eyes were improved, and 3 eyes unchanged. The preoperative and postoperative BCVA were 0.17 ± 0.10 and 0.37 ＋ 0.22, respectively, there was statistical difference （ P 〈 0.05 ）. The preoperative and postoperative central foveal thickness （CFT） were （498. 07 ± 116. 95） μm and （329.46 ± 111.15 ） μm, respectively,there was statistical difference （ t = 7.730 ,P 〈 0.05 ）. The postoperative BCVA was obvious linear correlated with the postoperative CFT （ r = 0. 413 ,P = 0. 029 ）. In the follow up, the postoperative CFT of most patients could not decrease to normal. Conclusion Although significant visual acuity improvement and anatomical recovery are detected after idiopathic macular epiretinal membrane removal, full restoration of CFT can not be achieved in most patients.