| 巩膜外黄斑外垫压术治疗硅油填充术后复发性超高度近视黄斑裂孔性视网膜脱离 |
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| 引用本文： | 石莲军,张苏,徐向忠,姚进,沈轶. 巩膜外黄斑外垫压术治疗硅油填充术后复发性超高度近视黄斑裂孔性视网膜脱离[J]. 眼科新进展, 2019, 0(3): 267-269. DOI: 10.13389/j.cnki.rao.2019.0060 |
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| 作者姓名： | 石莲军 张苏 徐向忠 姚进 沈轶 |
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| 作者单位： | 210000 江苏省南京市，南京医科大学眼科医院 |
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| 摘 要： | 目的探讨巩膜外黄斑外垫压术治疗硅油填充术后复发性超高度近视黄斑裂孔性视网膜脱离(macular hole retinal detachment,MHRD)的可行性及疗效。方法回顾性分析2016年6月至2018年1月玻璃体切割硅油填充术后的复发性超高度近视MHRD患者10例(10眼),所有患者均由同一术者行巩膜外黄斑外垫压术,将MEDPOR种植体+人造血管+环扎条带制成的"三明治加压块"固定垫压于黄斑区,术后行眼眶CT检查明确加压块位置。术后6～12个月取出硅油。术后随访18个月,观察并记录术后并发症、视网膜脱离复位、黄斑裂孔闭合情况、术后视力、眼轴长度等指标。结果眼眶CT显示10眼加压块均位于黄斑区;末次随访SD-OCT示10眼视网膜完全复位,7眼黄斑裂孔完全闭合,3眼黄斑裂孔部分闭合; 9眼术后最佳矫正视力(best corrected visual acuity,BCVA)较术前提高,1眼提高不明显;术前患者BCVA为(1. 55±0. 26) Log MAR,术后3个月BCVA为(0. 99±0. 05) Log MAR,与术前比较差异有统计学意义(P <0. 001);术前患者眼轴长度为(31. 27±1. 18) mm,术后3个月为(28. 81±0. 87) mm,与术前比较差异有统计学意义(P <0. 001)。所有患眼均未发生眼底出血、眼内炎、涡静脉回流障碍、眼前部缺血综合征等并发症。结论巩膜外黄斑外垫压术是治疗硅油填充术后复发性超高度近视MHRD安全有效的手术方法,能提高视网膜解剖复位率、黄斑裂孔闭合率和视力。
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| 关 键 词： | 超高度近视 复发性超高度近视黄斑裂孔性视网膜脱离 黄斑外垫压术 MEDPOR种植体 |
Macular scleral buckle for recurrent macular hole retinal detachment after vitrectomy with silicone oil tamponade in ultra-high myopia eyes |
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| SHI Lian-Jun,ZHANG Su,XU Xiang-Zhong,YAO Jin,SHEN Yi. Macular scleral buckle for recurrent macular hole retinal detachment after vitrectomy with silicone oil tamponade in ultra-high myopia eyes[J]. Recent Advances in Ophthalmology, 2019, 0(3): 267-269. DOI: 10.13389/j.cnki.rao.2019.0060 |
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| Authors: | SHI Lian-Jun ZHANG Su XU Xiang-Zhong YAO Jin SHEN Yi |
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| Affiliation: | Affiliated Eye Hospital of Nanjing Medical University，Nanjing 210000，Jiangsu Province，China |
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| Abstract: | Objective To evaluate the feasibility and efficacy of macular ablation in the treatment of recurrent macular hole retinal detachment (MHRD) in ultra-high myopia after vitrectomy with silicone oil tamponade.Methods Ten patients (10 eyes) with recurrent ultra-high myopia MHRD after vitrectomy combined with silicone oil tamponade from June 2016 to January 2018 were enrolled and the clinical data were retrospectively analyzed.All patients were treated with macular buckle using a “sandwich structure compression block” made of MEDPOR implant+artificial blood vessels+entangled strip which operated by the same surgeon.The position of the pressure block was examined by orbital CT after operation.The patients were followed up for 18 months，and silicone oil was eliminated after 6-12 months.Postoperative complications，retinal detachment，macular hole closure，postoperative visual acuity，axial length and other indicators were observed and recorded.Results Orbital CT showed that 10 blocks were all in the macular area；the last follow-up SD-OCT showed complete retinal reattachment achieved in all 10 eyes，including macular hole completely closed in 7 eyes and partially closed in 3 eyes；finally，9 eyes had the best corrected visual acuity (BCVA) improved and the improvement was not obvious in one eye；the average preoperative BCVA was (1.55±0.26)LogMAR and (0.99±0.05)LogMAR at 3 months postoperatively，and the difference was statistically significant (P<0.001)；the average axial length of the patients before surgery was (31.27±1.18)mm and the postoperative 3 months was (28.81±0.87)mm，and the difference was statistically significant (P<0.001).There was no complication such as fundus hemorrhage，endophthalmitis，vortex venous reflux disorder，anterior ischemic syndrome in all eyes.Conclusion Macular scleral buckle is a safe and effective surgical method for the treatment of recurrent ultra-high myopia MHRD after vitrectomy with silicone oil tamponade.It may improve the rate of retinal reattachment，macular hole closure and visual acuity. |
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| Keywords: | ultra-high myopia recurrent MHRD macular scleral buckle MEDPOR implant |
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