玻璃体切除术中内界膜剥除联合空气填充治疗玻璃体黄斑牵拉综合征的效果观察

Observation on the efficacy of internal limiting membrane peeling combined with air tamponade in vitrectomy for vitreomacular traction syndrome

目的观察玻璃体切除术中内界膜剥除联合消毒空气填充治疗玻璃体黄斑牵拉综合征的效果。方法回顾性病例对照研究。纳入郑州市第二人民医院2022年3月至2023年12月玻璃体黄斑牵拉综合征40例(40眼),所有患者均行玻璃体切除术中内界膜剥除联合玻璃体腔填充治疗,根据玻璃体腔填充物分为两组,其中玻璃体腔消毒空气填充组(空气组)20眼,平衡盐液填充组(液体组)20眼。术后随访3个月,比较两组患者手术前后最佳矫正视力(BCVA,logMAR)、黄斑中心区厚度(CMT),黄斑中心区视网膜振幅反应密度。结果两组术前在年龄、性别、BCVA、眼压、CMT及黄斑中心区视网膜振幅反应密度差异均无统计学意义(均P>0.05)。空气组术后1、3个月BCVA分别为0.41±0.14和0.34±0.15,液体组分别为0.39±0.13和0.35±0.13,两组组间术后1、3个月视力比较差异无统计学意义(t=-0.35,P=0.729;t=0.33,P=0.743)。空气组术后1、3个月CMT分别为(323.10±26.49)和(251.15±17.12)μm,液体组分别为(323.05±18.58)和(255.25±15.26)μm,两组组间术后1、3个月CMT比较差异均无统计学意义(t=-0.01,P=0.995;t=-0.80,P=0.429)。空气组术后1、3个月黄斑中心区视网膜振幅反应密度分别为(21.93±5.23)和(30.99±4.12)nV/deg^(2),液体组分别为(22.42±5.33)和(30.94±4.03)nV/deg^(2),两组组间术后1、3个月黄斑中心区视网膜振幅反应密度比较差异无统计学意义(t=-0.29,P=0.773;t=0.04,P=0.972)。结论玻璃体切除术中空气及平衡盐液两种填充物治疗均能安全有效地治疗玻璃体黄斑牵拉综合征,改善视功能。

Objective To observe the efficacy of vitrectomy with internal limiting membrane peeling with air tamponade for vitreomacular traction syndrome.Methods This was a retrospective case-control study.Clinical data of 40 cases(40 eyes)of vitreomacular traction syndrome treated with vitrectomy combined with internal limiting membrane peeling and vitreous cavity tamponade with air or balanced salt solution(BSS)in Zhengzhou Second People’s Hospital from Mar.2022 to Dec.2023 were collected.They were divided into two groups based on fillers,with 20 eyes in the air group(applied with air filling in the vitreous cavity)and 20 eyes in the liquid group(applied with balanced salt solution filling).The best corrected visual acuity(BCVA,logMAR),central macular thickness(CMT),and amplitude response density of the macular center before and after surgery between the two groups were compared.The follow-up time was 3 months after surgery.Results There were no differences in age,gender,BCVA,intraocular pressure,CMT,and central macular retinal amplitude response density between the two groups before surgery(all P>0.05).Postoperative BCVA of the air group at 1 and 3 months were 0.41±0.14 and 0.34±0.15.BCVA of the liquid group at 1 month and 3 months were 0.39±0.13 and 0.35±0.13.There was no statistically significant difference between the two groups at 1 month and 3 months after surgery(t=-0.35,P=0.729;t=0.33,P=0.743).The CMT of the air group at 1 month and 3 months after surgery was(323.10±26.49)and(251.15±17.12)μm,and the CMT of the liquid group at 1 month and 3 months after surgery was(323.05±18.58)and(255.25±15.26)μm.There were no statistically significant differences between the two groups at 1 month and 3 months after surgery(t=-0.01,P=0.995;t=-0.80,P=0.429).The central macular retinal amplitude response density of the air group at 1 month and 3 months after surgery were(21.93±5.23)and(30.99±4.12)nV/deg^(2).The central macular retinal amplitude response density of the liquid group at 1 month and 3 months after surgery were(22.42±5.33)and(30.94±4.03)nV/deg^(2).There were no statistically significant differences between the two groups at 1 month and 3 months after surgery(t=-0.29,P=0.773;t=0.04,P=0.972).Conclusion Vitrectomy and internal limiting membrane peeling with air or balanced salt solution tamponade in vitreous cavity can safely and effectively treat vitreomacular traction syndrome and improve visual function.