摘要
目的应用玻璃体切除联合内界膜翻转覆盖法治疗特发性黄斑裂孔(IMH),观察术后黄斑裂孔解剖结构及视力的变化情况。方法选取临床确诊IMH患者31例(31只眼),其中男性8例(8只眼),女性23例(23只眼),患者年龄范围:42~82岁,平均(65.68±8.39)岁,行23G玻璃体切除联合内界膜翻转覆盖及注气术。于术后5 d,2周,1、3、6个月进行随访,所有患眼手术前后行最佳矫正视力(BCVA)、裂隙灯,眼底广角眼底照相,频域相干光断层扫描(SD-OCT)检查。观察手术后患者黄斑裂孔愈合率,手术前后BCVA变化情况,黄斑裂孔的愈合类型,翻转覆盖的内界膜与裂孔的位置关系,椭圆体区缺损直径的变化情况。结果术后黄斑裂孔愈合率为100%。手术前后BCVA有显著性差异(t=8.50,P<0.05),术后视力提高。30例裂孔呈"U"型愈合,1例裂孔呈"V"型愈合。29例内界膜瓣完全贴附于视网膜,2例内界膜未完全贴附视网膜并成桥样附着在裂孔正上方。术后椭圆体缺失直径逐渐减小。结论玻璃体切除联合内界膜瓣翻转覆盖术治疗IMH可以取得较高的解剖学复位率和裂孔愈合率,提高视力患者视力,是治疗IMH一种安全有效的手术方法。
Objective To observe the anatomical and visual outcomes of idiopathic macular holes(IMH) treated with pars plana vitrectomy( PPV) and inverted internal limiting membrane( ILM) flap technique. Methods Thirty-one IMH patients(31 eyes),8 males and 23 females,were included. The age ranged from 42 to 82 with a mean of 65. 68 ±8. 39 years. All patients were treated with PPV and ILM flap technique. Best correct visual acuity( BCVA),slit-lamp examination,ultra-wide-field fundus photograph and spectral optical coherence tomography( SD-OCT) were performed before the surgery and 5 days,2 weeks,1,3,and 6 months after the surgery. Results The closure rate of IMHs was 100%.Postoperative BCVA significantly improved( t = 8. 50,P〈 0. 05). U-type closure was found in majority of the patients(n = 30) and V-type closure was found in 1 patient. ILM flap attached to retinal completely in 29 eyes,and bridged IMH in 2 eyes. The diameter of ellipsoid zone gradually decreased postoperatively. Conclusions Vitrectomy combined with inverted ILM flap technique for the treatment of IMH can achieve a higher closure rate and better postoperatively visual outcomes.It is a safe and effective surgical method for the treatment of IMH.
出处
《临床眼科杂志》
2018年第1期10-13,共4页
Journal of Clinical Ophthalmology
基金
国家临床重点专科基金资助项目[编号:卫办医政函(2012)649号]
关键词
特发性黄斑裂孔
内界膜翻转覆盖
相光干断层扫描
椭圆体区
Idiopathic macular hole
Inverted internal limiting membrane flap technique
OCT
Ellipsoid zone