玻璃体切割联合内界膜填塞手术治疗高度近视合并黄斑裂孔性视网膜脱离

发布时间：2018-12-09 10:37

【摘要】：目的:观察玻璃体切割联合内界膜填塞手术治疗高度近视合并黄斑裂孔性视网膜脱离的效果。方法:对2013年1月—2014年12月在南京医科大学附属眼科医院接受治疗的45例(47眼)高度近视黄斑裂孔性视网膜脱离的患者进行回顾性分析。所有患者采用23G微创玻璃体切割手术,其中24眼行自体内界膜剥除并填塞手术(填塞组);23眼单纯内界膜剥除术(未填塞组)。术后随访6~12个月,观察手术前后视力、眼压、眼底照相、FFA、黄斑光学相干断层成像、网膜复位及黄斑裂孔闭合情况。结果:填塞组与未填塞组术前视力分别为(1.63±0.48)LogMAR和(1.65±0.48)LogMAR,术后6~12个月时患者的视力分别为(1.00±0.12)LogMAR和(1.04±0.07)LogMAR,两组间差异无统计学意义(P0.05),两组术前术后差异有统计学意义(P0.001);填塞组黄斑裂孔闭合率为91.6%(22/24),未填塞组黄斑裂孔闭合率为65.2%(15/23),两组间差异有统计学意义(P0.05);填塞组网膜均复位,无视网膜脱落复发,未填塞组视网膜脱落复发率为8.6%(2/23)。结论:玻璃体切割联合内界膜填塞手术,从解剖上封闭黄斑裂孔,是一种安全有效的治疗高度近视合并黄斑裂孔性视网膜脱离的方法。
[Abstract]:Objective: to observe the effect of vitrectomy combined with internal membrane tamponade in the treatment of high myopia with macular hole retinal detachment. Methods: from January 2013 to December 2014, 45 patients (47 eyes) with high myopia with macular hole retinal detachment received treatment in the affiliated ophthalmological hospital of Nanjing Medical University were analyzed retrospectively. All the patients were treated with 23 G minimally invasive vitrectomy, of which 24 eyes were treated with autoclave membrane dissection and tamponade (tamponade group) and 23 eyes with simple internal boundary membrane excision (non-tamponade group). The visual acuity, intraocular pressure, fundus photography, FFA, macular optical coherence tomography, omentum reduction and macular hole closure were observed. Results: the preoperative visual acuity was (1.63 卤0.48) LogMAR and (1.65 卤0.48) LogMAR, respectively, and the visual acuity was (1.00 卤0.12) LogMAR and (1.04 卤0.07) LogMAR, respectively. There was no significant difference between the two groups (P0.05), the two groups before and after the difference was statistically significant (P0.001); The closure rate of macular hole was 91.6% (22 / 24) in the stuffing group and 65.2% (15 / 23) in the unfilled group. The difference between the two groups was statistically significant (P0.05). There was no recurrence of retinal detachment. The recurrence rate of retinal detachment in unfilled group was 8.6% (2 / 23). Conclusion: vitrectomy combined with internal membrane tamponade is a safe and effective method for the treatment of high myopia with macular hole retinal detachment.
【作者单位】：南京医科大学附属眼科医院;
【分类号】：R779.6

【参考文献】