特发性黄斑前膜术后黄斑解剖结构和功能恢复研究

Study on the recovery of structure and function of the macular anatomy of idiopathic macular epiretinal membrane surgery

目的 研究特发性黄斑前膜（Idiopathic macular epiretinal membrane,IMEM）经玻璃体切割联合黄斑前膜剥除手术后,黄斑解剖结构及视功能恢复情况,探讨影响IMEM术后视力恢复的因素.方法 临床病例系列研究.对2012年2月至2013年7月在安阳眼科医院入院行手术治疗的IMEM患者52例（54只眼）,收集患者术前的最佳矫正视力（best corrected visual acuity,BCVA）、黄斑中心凹厚度（central foveal thickness,CFT）,视物变形情况,术后随访4～8个月,平均（6.5±1.1）个月,所得数据进行配对资料t检验和pearson相关性分析.结果 IMEM患者术前术后BCVA对比差异有统计学意义,P ＜0.05（t=2.17;P=0.04）,术前、术后CFT比较差异有统计学意义,P＜0.05（t=9.75;P =0.00）,术前CFT与术前视力及术后视力经Pearson相关性分析差异无统计学意义（r=0.03,0.17;P =0.81,0.23）,术后CFT与术后视力经相关性分析差异有统计学意义（r=0.27;P=0.05）,术前BC-VA与术后BCVA经相关性分析差异有统计学意义（r=0.78;P=0.00）,术前CFT与术后CFT经相关性分析差异有统计学意义（r=0.47;P=0.00）.结论 经玻璃体切割联合黄斑前膜剥除手术后,IMEM患者CFT较术前降低,视力有所提高,但是术前CFT似对患者最终的视力恢复无明显关系,患者术后恢复更多取决于术前的视力,而不是黄斑中心凹的厚度.

Objective To study the influence of anatomic preoprerative characteristics and functional characteristics on functional recovery after epiretinal membrane surgery.Methods There were 52 cases （54 eyes）.Best corrected visual acuity （BCVA）,metamorphopsia,central foveal thickness （CFT） before and after surgery were analyzed.All data was collected during the followed up period about （6.5±1.1） months.Results There were significant difference between preoperative and postoperative on BCVA （P =0.04）.There were significant different between preoperative and postoperative on CFT （P =0.00）.No significant correlation was found between preoperative or postoperative BCVA and preoperative CFT （r =0.03,0.17; P =0.81,0.23）.There were little correlation between postoperative CFT and postoperative BCVA （r =0.27; P =0.05）.A significant correlation was found between preoperative and postoperative BCVA （r =0.78; P =0.00）,and common correlation was found between preoperative and postoperative CFT （r =0.47; P =0.00）.Conclusions An improvement is observed in BCVA and CFT after epiretinal membrane surgery.A significant correlation is found between preoperative and postoperative on BCVA,but not between BCVA and CFT.