内界膜翻转填塞联合自体血封闭术治疗大孔径特发性黄斑裂孔

Inverted internal limiting membrane flap technique combined with autologous blood for the treatment of large idiopathic macular holes

目的观察内界膜翻转填塞联合自体血封闭术治疗大孔径特发性黄斑裂孔的疗效。方法回顾性分析18例18眼特发性黄斑裂孔的临床资料,黄斑裂孔最小孔径>400μm,均行玻璃体切割+内界膜翻转填塞+自体血封闭术,术后随访3个月。观察最佳矫正视力、黄斑裂孔闭合情况及并发症情况。结果 18眼中,17眼黄斑裂孔闭合,闭合率94.4%。术后最佳矫正视力提高者16眼,不变者2眼。术前最佳矫正视力为(1.15±0.42)log MAR,术后为(0.53±0.23)log MAR,差异有统计学意义(t=7.381,P=0.000)。术中及术后均未见严重并发症发生。结论内界膜翻转填塞联合自体血封闭术治疗大孔径特发性黄斑裂孔是安全有效的,但仍需要大样本、长期观察对该术式进行更完善评估。

Objective To observe the efficacy of internal limiting membrane（ ILM）packing combined with autologous blood technique in the treatment of large idiopathic macular holes. Methods Eighteen eyes of 18 patients with idiopathic macular holes with the smallest diameter greater than 400 μm were included in this retrospective study. All the patients underw ent pars plana vitrectomy（ PPV） and ILMpacking combined with autologous blood technique,and the follow-up was 3 months. The best corrected visual acuity（ BC VA）,and anatomical closure were observed. Results The macular holes closed in 17 eyes,and the closure rate was 94. 4%. Sixteen eyes had postoperative BC VA better than preoperative BC VA,2 eyes had the same BC VA,and no eyes had worse postoperative BC VA than preoperative data. The mean BC VA improved from（ 1. 15 ± 0. 42） log MAR preoperatively to（ 0. 53 ± 0. 23） log MAR postoperatively,and the difference was statistically significant（ t=7. 381,P=0. 000）. No complications were observed. Conclusion ILMpacking combined with autologous blood technique for the treatment of large idiopathic macular hole is safe and effective. How ever,large sample and long-term observations are needed to make a better assessment of this procedure.