后巩膜加固术治疗高度近视黄斑劈裂的远期效果

Long-term efficacy of posterior scleral reinforcement for maculoschisis in high myopia

目的评价后巩膜加固术治疗高度近视黄斑劈裂的远期效果。方法回顾性分析高度近视黄斑劈裂以异体硬脑膜或异体巩膜进行后巩膜加固术30例（37眼）的临床资料术后随访5年。结果术后OCT显示37眼中视网膜劈裂腔消失33眼（89．2％），2眼劈裂无变化，2眼发展为黄斑孔。术后屈光度较术前降低，差异有统计学意义（χ2=47．910，P=0．000）。最佳矫正视力（BCVA）较术前提高，差异有统计学意义（t=5．034，P=0．011）。术前患者眼轴长度平均为（29．42±2．67）mm。术后6个月、1、3和5年依次为：（28．21±1．87）mm、（28．63±1．62）mm、（29．16±2．15）mm和（29．31±2．42）mm。结论后巩膜加固术治疗高度近视黄斑劈裂远期效果良好，可以稳定眼轴，改善视力。

Objective To evaluate long-term efficacy of posterior scleral reinforcement for the treatment of maculoschisis in high myopic eyes. Methods The data of 37 eyes of 30 cases with maeuloschisis in high myopia eyes were collected and analyzed retrospectively, they underwent scleral reinforcement with allodural or allogeneic sclera, and the followed-up time was 5 years. Results After surgery, all cases were examined with optical coherence tomography （OCT）. The splitting cavity of retina disappeared in 33 eyes（89.2% ）. The splitting wasn＇ t improved in 2 eyes. The macular hole occurred in 2 eyes. After surgery, the refractive degree was lower, and the difference was statistically significant （X2 = 47. 910, P = 0. 000）. The best corrected visual acuity （BCVA） were improved after surgery, and the difference was statistically significant（ t = 5. 034, P = 0. 011 ）. The mean length of the ocular axis in patients before surgery was （29.42 ± 2.67） mm. After 6 months, 1, 3 and 5 years, the length of axis were respectively： （28.21 ±1.87）mm, （28.63±1.62）mm, （29.16±2.15）mm and （29.31±2.42）mm. Conclusion Posterior scleral reinforcement surgery in the treatment of high myopia and maculoschisis is effective , it can stable eye axis and improve visual acuity.