AIM：To investigate the effect of internal limiting membrane transplantation and autologous blood on treating refractory giant macular hole.METHODS：Thirty-seven eyes with giant macular hole of the smallest hole diame...AIM：To investigate the effect of internal limiting membrane transplantation and autologous blood on treating refractory giant macular hole.METHODS：Thirty-seven eyes with giant macular hole of the smallest hole diameter 〉700 μm,the maximum diameter of the substrate 〉1000 μm and hole formation factor 〈0.6 underwent surgical treatment.The patients were randomly divided into two groups.Nineteen eyes with surgical flip of the internal limiting membrane in group A,18 eyes with internal limiting membrane transplantation in group B who underwent the tamponade of internal limiting membrane into the hole,autologous plasma was used to seal the hole.The patients were followed up for 3 mo,optical coherence tomography and best corrected visual acuity（BCVA） were recorded before and after operation,and the results were statistically analyzed.RESULTS：At 3 mo after operation,BCVA of the two groups was significantly improved compared with that before operation（tA=4.192,tB=4.374,P〈0.05）.But there was no significant difference in visual acuity between the two groups（χ^2=0.128,P〉0.05）.At 3 mo after operation,the closure rate of group A was 68.4%,and 100% in group B.（χ^2=5.628,P〈0.05）.The defect diameter of inner segment/outer segment at 3 mo after the operation was significantly lower than that before operation（tA=12.287,tB=15.481,P〈0.05）,and the difference was statistically significant（t=2.552,P〈0.05）.CONCLUSION：Internal limiting membrane transplantation combined with autologous whole blood can improve the postoperative closure rate of the refractory large aperture,and can effectively improve the postoperative visual acuity.展开更多
目的比较经睫状体平坦部玻璃体切割术(PPV)联合内界膜翻转覆盖术与PPV联合游离内界膜移植术治疗大直径黄斑裂孔(MH)的临床疗效和安全性。方法将40例(40只眼)大直径MH(最小直径>400μm)患者按随机数字表法分为翻转组(n=20,20只眼)和...目的比较经睫状体平坦部玻璃体切割术(PPV)联合内界膜翻转覆盖术与PPV联合游离内界膜移植术治疗大直径黄斑裂孔(MH)的临床疗效和安全性。方法将40例(40只眼)大直径MH(最小直径>400μm)患者按随机数字表法分为翻转组(n=20,20只眼)和移植组(n=20,20只眼)。翻转组采用PPV联合内界膜翻转覆盖术治疗,移植组采用PPV联合游离内界膜移植术治疗。观察2组术后2周裂孔闭合率,术前和术后2周和术后1、3、6个月最小视角对数视力表最佳矫正视力(log MAR BCVA)、眼压的水平及术后手术相关并发症、随访6个月的裂孔复发情况。频域光学相干断层成像(SD-OCT)的图像观察MH直径(测量MH最小直径及基底部最大直径)及MH是否闭合。结果术后2周翻转组裂孔闭合率为100.0%,移植组为95.0%。2组术后2周裂孔闭合率比较差异无统计学意义(P>0.05)。log MAR BCVA:翻转组术前为1.01±0.24,术后2周为0.82±0.32和术后1个月为0.72±0.45、术后3个月为0.52±0.25、术后6个月为0.53±0.42;移植组术前为1.09±0.32,术后2周为0.95±0.45和术后1个月为0.93±0.14、术后3个月为0.81±0.24、术后6个月为0.70±0.23。2组术后log MAR BCVA均较术前明显提高,差异有统计学意义(P<0.05);翻转组术后2周和术后1、3、6个月log MAR BCVA均较移植组明显提高,差异有统计学意义(P<0.05)。2组术后2周和术后1、3、6个月眼压与术前比较差异无统计学意义(P>0.05);2组术后均未出现手术相关并发症;2组均随访6个月,均无裂孔复发。结论PPV联合内界膜翻转覆盖术治疗大直径MH效果与PPV联合游离内界膜移植术治疗相当,但翻转组术后log MAR BCVA优于移植组。展开更多
目的探讨视网膜内界膜移植治疗特发性黄斑裂孔的疗效。方法回顾性分析对裂孔形成因子(Hole Form Factor,HFF)值<0.6的40例特发性黄斑裂孔患者行手术治疗,其中A组患者行常规玻璃体切割联合内界膜剥除20只眼,B组患者行玻璃体切割联合...目的探讨视网膜内界膜移植治疗特发性黄斑裂孔的疗效。方法回顾性分析对裂孔形成因子(Hole Form Factor,HFF)值<0.6的40例特发性黄斑裂孔患者行手术治疗,其中A组患者行常规玻璃体切割联合内界膜剥除20只眼,B组患者行玻璃体切割联合内界膜剥除及内界膜移植20只眼,术后随诊3个月以上,记录术前、术后3月的最佳矫正视力(best corrected visual acuity BCVA),OCT结果并进行统计学分析。结果术后3月A组裂孔闭合率为70%,B组裂孔闭合率为100%,差异具有统计学意义(χ2=7.059,P<0.05);术后3月两组BCVA与术前相比明显提高(tA=4.017,tB=4.430,P<0.05),两组之间视力改善比较差异无明显统计学意义(χ2=0.173,P>0.05),但视力显著改善者差异有明显统计学意义(χ2=4.912,P<0.05);术后3月两组光感受器内外节连接(IS/OS)缺损直径较术前均明显减小,差异有统计学意义(tA=19.139,tB=13.891,P<0.05),两组之间对比差异有统计学意义(t=2.445,P<0.05)。结论内界膜移植可提高HFF值<0.6特发性黄斑裂孔的术后闭合率,是一种安全有效的手术方式。展开更多
目的分析微创玻璃体切除联合自体游离内界膜移植及消毒空气填充治疗大直径黄斑裂孔的手术疗效及其视功能预后。方法收集2017年2月至2018年12月就诊的大直径黄斑裂孔患者13例(13只眼),常规微创玻璃体切除后,均采用自体游离内界膜移植联...目的分析微创玻璃体切除联合自体游离内界膜移植及消毒空气填充治疗大直径黄斑裂孔的手术疗效及其视功能预后。方法收集2017年2月至2018年12月就诊的大直径黄斑裂孔患者13例(13只眼),常规微创玻璃体切除后,均采用自体游离内界膜移植联合消毒空气填充。患眼在术前及术后10 d、1个月、3个月进行最佳矫正视力(BCVA)、扫频相干光层析成像术(SD-OCT)检查黄斑中心凹结构,分析比较随访时最小分辨角对数(LogMAR)BCVA的变化。结果术后SD-OCT发现所有入选患者的大直径黄斑裂孔均完全闭合.术后10 d LogMAR BCVA平均值上升至0.70±0.22(0.4~1.1),与手术前Log MAR BCVA平均值1.09±0.13(0.9~1.3)比较,差异有统计学意义(P<0.05),与术后3个月LogMAR BCVA平均值0.68±0.22(0.4~1.1)比较,差异无统计学意义(P>0.05)。结论微创玻璃体切除联合游离内界膜移植及空气填充对治疗大直径黄斑裂孔有良好疗效,患者术后裂孔闭合,视力提高。展开更多
文摘AIM：To investigate the effect of internal limiting membrane transplantation and autologous blood on treating refractory giant macular hole.METHODS：Thirty-seven eyes with giant macular hole of the smallest hole diameter 〉700 μm,the maximum diameter of the substrate 〉1000 μm and hole formation factor 〈0.6 underwent surgical treatment.The patients were randomly divided into two groups.Nineteen eyes with surgical flip of the internal limiting membrane in group A,18 eyes with internal limiting membrane transplantation in group B who underwent the tamponade of internal limiting membrane into the hole,autologous plasma was used to seal the hole.The patients were followed up for 3 mo,optical coherence tomography and best corrected visual acuity（BCVA） were recorded before and after operation,and the results were statistically analyzed.RESULTS：At 3 mo after operation,BCVA of the two groups was significantly improved compared with that before operation（tA=4.192,tB=4.374,P〈0.05）.But there was no significant difference in visual acuity between the two groups（χ^2=0.128,P〉0.05）.At 3 mo after operation,the closure rate of group A was 68.4%,and 100% in group B.（χ^2=5.628,P〈0.05）.The defect diameter of inner segment/outer segment at 3 mo after the operation was significantly lower than that before operation（tA=12.287,tB=15.481,P〈0.05）,and the difference was statistically significant（t=2.552,P〈0.05）.CONCLUSION：Internal limiting membrane transplantation combined with autologous whole blood can improve the postoperative closure rate of the refractory large aperture,and can effectively improve the postoperative visual acuity.
文摘目的比较经睫状体平坦部玻璃体切割术(PPV)联合内界膜翻转覆盖术与PPV联合游离内界膜移植术治疗大直径黄斑裂孔(MH)的临床疗效和安全性。方法将40例(40只眼)大直径MH(最小直径>400μm)患者按随机数字表法分为翻转组(n=20,20只眼)和移植组(n=20,20只眼)。翻转组采用PPV联合内界膜翻转覆盖术治疗,移植组采用PPV联合游离内界膜移植术治疗。观察2组术后2周裂孔闭合率,术前和术后2周和术后1、3、6个月最小视角对数视力表最佳矫正视力(log MAR BCVA)、眼压的水平及术后手术相关并发症、随访6个月的裂孔复发情况。频域光学相干断层成像(SD-OCT)的图像观察MH直径(测量MH最小直径及基底部最大直径)及MH是否闭合。结果术后2周翻转组裂孔闭合率为100.0%,移植组为95.0%。2组术后2周裂孔闭合率比较差异无统计学意义(P>0.05)。log MAR BCVA:翻转组术前为1.01±0.24,术后2周为0.82±0.32和术后1个月为0.72±0.45、术后3个月为0.52±0.25、术后6个月为0.53±0.42;移植组术前为1.09±0.32,术后2周为0.95±0.45和术后1个月为0.93±0.14、术后3个月为0.81±0.24、术后6个月为0.70±0.23。2组术后log MAR BCVA均较术前明显提高,差异有统计学意义(P<0.05);翻转组术后2周和术后1、3、6个月log MAR BCVA均较移植组明显提高,差异有统计学意义(P<0.05)。2组术后2周和术后1、3、6个月眼压与术前比较差异无统计学意义(P>0.05);2组术后均未出现手术相关并发症;2组均随访6个月,均无裂孔复发。结论PPV联合内界膜翻转覆盖术治疗大直径MH效果与PPV联合游离内界膜移植术治疗相当,但翻转组术后log MAR BCVA优于移植组。
文摘目的分析微创玻璃体切除联合自体游离内界膜移植及消毒空气填充治疗大直径黄斑裂孔的手术疗效及其视功能预后。方法收集2017年2月至2018年12月就诊的大直径黄斑裂孔患者13例(13只眼),常规微创玻璃体切除后,均采用自体游离内界膜移植联合消毒空气填充。患眼在术前及术后10 d、1个月、3个月进行最佳矫正视力(BCVA)、扫频相干光层析成像术(SD-OCT)检查黄斑中心凹结构,分析比较随访时最小分辨角对数(LogMAR)BCVA的变化。结果术后SD-OCT发现所有入选患者的大直径黄斑裂孔均完全闭合.术后10 d LogMAR BCVA平均值上升至0.70±0.22(0.4~1.1),与手术前Log MAR BCVA平均值1.09±0.13(0.9~1.3)比较,差异有统计学意义(P<0.05),与术后3个月LogMAR BCVA平均值0.68±0.22(0.4~1.1)比较,差异无统计学意义(P>0.05)。结论微创玻璃体切除联合游离内界膜移植及空气填充对治疗大直径黄斑裂孔有良好疗效,患者术后裂孔闭合,视力提高。
