黄斑部按摩联合负压吸引治疗大型特发性黄斑孔的效果

Efficacy of macular massage combined with negative pressure suction for giant idiopathic macular hole

目的:评估25 G玻璃体切除联合黄斑部按摩并负压吸引治疗大型特发性黄斑孔的临床效果。方法:回顾性分析2016年4月至2018年12月武汉汉阳艾格眼科医院收治的大型特发性黄斑孔27例(27眼)的临床资料。患者孔径500~800μm。所有患者均行25 G玻璃体切除术,术中剥离内界膜后以笛针按摩黄斑部,将视网膜由外向中心凹方向按摩牵引,利用笛针负压吸引辅助黄斑孔闭合。结果:术后3~5天黄斑孔闭合25眼(92.6%),术后最佳矫正视力(logMAR)为1.04±0.37较术前的1.28±0.30提高(t=3.860,P=0.032);术前及术后眼压均在正常范围内,差异无统计学意义(t=2.147,P=0.226);术中及随访期间均未见医源性损伤、出血、视网膜脱离或继发性青光眼等并发症发生。结论:25 G玻璃体切除联合黄斑部按摩及笛针负压吸引治疗大型特发性黄斑孔效果显著。

Objective To evaluate the efficacy of 25 G vitrectomy combined with macular massage and negative pressure suction for the treatment of giant idiopathic macular hole.Methods Clinical data of 27 eyes of 27 patients with giant idiopathic macular hole,of which the diameter was 500-800μm,from Apr.2016 to Dec.2018 in Hanyang Eyegood Ophthalmic Hospital was analyzed retrospectively.Macular massage and negative pressure suction with flute needle were performed after 25 G vitrectomy and peeling of the inner limiting membrane.Results Macular hole closure at 3-5 days postoperatively occurred in 25 eyes(92.6%).Best corrected visual acuity(BCVA,logMAR)at 3-5 days postoperatively were ameliorated from 1.28±0.30 to 1.04±0.37(t=3.860,P=0.032).The postoperative intraocular pressure(IOP)was similar to the preoperative IOP within normal limits(t=2.147,P=0.226).No complication such as iatrogenic injury of macular,bleeding,retinal detachment or secondary glaucoma was recorded in the intra-operative and the follow-up period.Conclusion 25 G vitrectomy combined with macular massage and negative pressure suction contributes to the anatomical repair and visual function recovery of patients with giant idiopathic macular hole.