| 玻璃体切割联合内界膜填塞或内界膜翻转对特发性大黄斑裂孔患者治疗效果的对比研究 |
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| 引用本文： | 黄志坚,陈晓,洪玲,曾苗.玻璃体切割联合内界膜填塞或内界膜翻转对特发性大黄斑裂孔患者治疗效果的对比研究[J].眼科新进展,2020,0(1):058-61. |
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| 作者姓名： | 黄志坚 陈晓 洪玲 曾苗 |
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| 作者单位： | 430070 湖北省武汉市，中国人民解放军中部战区总医院眼科 |
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| 摘 要： | 目的 比较玻璃体切割联合内界膜填塞或内界膜翻转在特发性大黄斑裂孔患者治疗中的效果。方法 回顾性非随机临床研究。24例24眼特发性大黄斑裂孔患者均行睫状体平坦部三通道25G玻璃体切割术，术中使用内界膜反折填塞于黄斑裂孔中者12例12眼为内界膜填塞组，使用内界膜反折覆盖于黄斑裂孔中者12例12眼为内界膜翻转组。术后随访6个月，对比两组患者最佳矫正视力（best corrected visual acuity，BCVA）、裂孔闭合率、OCT检查结果及并发症等情况。结果 术后6个月，内界膜填塞组12眼黄斑裂孔全部闭合，黄斑裂孔闭合率为100%；内界膜翻转组12眼中11眼黄斑裂孔闭合，黄斑裂孔闭合率为91.67%，两组黄斑裂孔闭合率差异无统计学意义（Z=-1.00，P=0.32）。术后6个月，内界膜填塞组BCVA为（1.13±0.40）logMAR，内界膜翻转组为（1.03±0.36）logMAR，均较术前明显改善，差异均有统计学意义（均为P=0.00）；术后6个月内界膜翻转组BCVA优于内界膜填塞组，但差异无统计学意义（t=0.59，P=0.56）。OCT检查示，内界膜翻转组有3眼（25.00%）视网膜外层结构部分恢复，内界膜填塞组均未见视网膜外层结构恢复患者。结论 玻璃体切割联合内界膜填塞或内界膜翻转治疗特发性大黄斑裂孔，均能提高黄斑裂孔的闭合率，稳定及改善BCVA。
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| 关 键 词： | 特发性大黄斑裂孔 内界膜填塞 内界膜翻转 玻璃体切割术 |
Comparative study between PPV combined with internal limiting membrane insertion and inverted internal limiting membrane for large idiopathic macular hole |
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| HUANG Zhijian,CHEN Xiao,HONG Ling,ZENG Miao.Comparative study between PPV combined with internal limiting membrane insertion and inverted internal limiting membrane for large idiopathic macular hole[J].Recent Advances in Ophthalmology,2020,0(1):058-61. |
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| Authors: | HUANG Zhijian CHEN Xiao HONG Ling ZENG Miao |
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| Affiliation: | Department of Ophthalmology,Central Theater Command of General Hospital,Wuhan 430070,Hubei Province,China |
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| Abstract: | Objective To compare the clinical efficacy of pars plana vitrectomy(PPV)combined with internal limiting membrane(ILM)insertion versus the inverted ILM for large idiopathic macular hole(MH).Methods The retrospective,non-randomized clinical study was conducted.Totally 24 patients(24 eyes)who were diagnosed with large idiopathic MH received three-channel 25G vitrectomy at the flat part of ciliary body.There were 12 eyes of 12 cases receiving inverted ILM insertion into MH,as ILM insertion group,another 12 eyes of 12 cases received inverted ILM covering MH,as inverted ILM group.All cases were followed up for 6 months,to compare best corrected visual acuity(BCVA),closure rate of macular holes,OCT results and complications.Results At the 6 months after surgery,MH closure was achieved in all eyes in ILM insertion group(100%),and observed in 11 eyes(91.67%)in the inverted ILM group.There was no statistical difference between the two groups(Z=-1.00,P=0.32).At the 6 months after surgery,the BCVA was(1.13±0.40)logMAR in ILM insertion group and(1.03±0.36)logMAR in inverted ILM group,both of which had obvious improvement compared with those before surgery,and significant difference was observed(all P=0.00).Visual improvement 6 months after surgery in inverted ILM group was better than that in ILM insertion group,but no statistical difference was found(t=0.59,P=0.56).OCT results showed that partial recovery of outer retinal structure was observed in 3 eyes of inverted ILM group(25.00%),but not found in ILM insertion group.Conclusion PPV combined with ILM insertion or inverted ILM can improve the visual acuity and steadily improve BCVA during the treatment of large idiopathic MH. |
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| Keywords: | large idiopathic macular hole internal limiting membrane insertion inverted internal limiting membrane pars plana vitrectomy |
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