23g玻璃体切割联合内界膜剥除治疗特发性黄斑裂孔的临床疗效观察

Clinical Observation of 23g Vitrectomy Combined with Internal Limiting Membrane Peeling for Idiopathic Macular Hole

目的:探讨23g玻璃体切割联合内界膜剥除治疗特发性黄斑裂孔的临床疗效。方法:选取我院2015年1月-2017年1月收治的49例(52眼)特发性黄斑裂孔患者作为研究对象,对所有患者给予23g玻璃体切割联合内界膜剥除治疗,比较手术前后术眼视力、眼压变化情况以及多焦视网膜电图(mfERG)一阶函数的1~2环P1波反应密度情况,同时统计围手术期并发症发生情况。结果:52眼术后视力有明显改善(P<0.01),手术前、后眼压比较差异无统计学意义(P>0.05)。52眼术后mfERG一阶函数的1环、2环P1波反应密度均较术前明显升高(P<0.01)。手术过程中未发生医源性裂孔、玻璃体出血、视网膜脱离、眼内炎等并发症。结论:23g玻璃体切割联合内界膜剥除治疗特发性黄斑裂孔能有效促进裂孔愈合及视力恢复,值得推广应用。

Objective：To investigate the clinical effect of 23 g vitrectomy combined with internal limiting membrane peeling for idiopathic macular hole.Methods：In our hospital from January 2015 to January 2017 49cases（52eyes）with idiopathic macular hole patients as the research object,all the patients were treated with 23 g vitreous body cutting combined with internal limiting membrane peeling treatment,compared before and after the operation of visual acuity,intraocular pressure and multifocal retinal electrogram（mfERG）a order function of 1~2ring P1 wave reaction density,and statistical perioperative complications.Results：The visual acuity of 52 eyes was significantly improved（P〈0.01）.There was no significant difference in IOP before and after operation（P〈0.05）.The 1~2ring P1 wave response density of the first order function of mfERG after operation in the 52 eyes was significantly higher than that before operation（P〈0.01）.There were no complications such as iatrogenic hole,vitreous hemorrhage,retinal detachment,endophthalmitis and so on.Conclusion：23g vitrectomy combined with internal limiting membrane peeling in the treatment of idiopathic macular hole can effectively promote the healing of fracture and visual acuity recovery,which is worthy of popularization and application.