特发性黄斑裂孔行玻璃体切除联合眼内空气填充术术后黄斑裂孔愈合的观察

Observation of macular hole healing after vitrectomy combined with intraocular air filling for idiopathic macular hole

目的观察玻璃体切除联合空气填充治疗特发性黄斑裂孔的疗效。方法选择我院2016-2018年入院,因特发性黄斑裂孔行玻璃体切除联合空气填充术治疗的患者52例,52眼,观察患者术后24h及1mo黄斑裂孔闭合率,术后俯卧位平均时间及术后并发症,比较患者术前及术后1mo和3mo最佳矫正视力,术前与术后3mo的椭圆体区破坏直径。结果术后24h、术后1mo和术后3mo黄斑裂孔闭合率分别为44眼(84.6%)、48眼(92.3%)和50眼(96.2%);所有患者最佳矫正视力术前为0.11±0.05,术后1、3mo最佳矫正视力分别为0.27±0.14、0.25±0.16,和术前比较,术后1mo和术后3mo时患者最佳矫正视力差异均有统计学意义(t=6.382、7.153,P均<0.001),术后1mo和术后3mo时患者最佳矫正视力比较差异无统计学意义(t=0.365,P=0.713)。术前与术后3mo的椭圆体区破坏直径分别为1945.4±462.5μm和1193.6±362.6μm (t=9.253,P<0.001)。患者术后俯卧位平均时间为3.6±0.3d。术后均未发生严重并发症。结论玻璃体切除术联合空气填充对于特发性黄斑裂孔患者的疗效可靠,可获得较高的闭合率,建议在临床上推广。

Objective To observe the effect of vitrectomy combined with air tamponade in the treatment of Idiopathic macular hole. Methods We selected 52 patients(52 eyes) who were admitted to our hospital from 2016 to 2018 and underwent vitrectomy combined with air tamponade for idiopathic macular hole,the macular hole closure rate, average time in prone position and postoperative complications were observed 24 hours and 1 mo after operation, the best corrected visual acuity(BCVA) was compared before and after operation for 1 mo and 3 mo, and the diameter of the destruction of the ellipsoid area was compared before and after operation for 3 mo.Result The macular hole closure rates were 44 eyes(84.6%), 48 eyes(92.3%) and 50 eyes(96.2%) at 24 h, 1 mo and 3 mo postoperative, respectively, the best corrected visual acuity was 0.11±0.05 before operation, 0.27±0.14 and 0.25±0.16 after 1 and 3 mo, respectively, the difference of the best corrected visual acuity between 1 mo and 3 mo postoperative was statistically significant( t=6.382,7.153, P<0.001), there was no significant difference in the best corrected visual acuity between 1 mo and 3 mo postoperative(t=0.365, P=0.713);The destruction diameters of the ellipsoidal area were 1945.4±462.5μm and 1193.6±362.6μm before and after 3 mo operation respectivel(t=9.253, P<0.001);The average duration of prone position was 3.6±0.3 d days.A small amount of blood oozed from the incision in 5 patients after operation, all of them absorbed by themselves, and the rest had no serious complications.Conclusion Vitrectomy combined with air tamponade is a reliable treatment for idiopathic macular hole,can obtain the high closure rate, proposes in the clinical promotion.