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| 空气填充联合内界膜翻转治疗伴有后巩膜葡萄肿的高度近视黄斑裂孔性视网膜脱离 | |
| 引用本文： | 佘海澄,齐越,金子兵,王宁利,段安丽.空气填充联合内界膜翻转治疗伴有后巩膜葡萄肿的高度近视黄斑裂孔性视网膜脱离[J].国际眼科杂志,2022,22(4):536-540. |
| 作者姓名： | 佘海澄 齐越 金子兵 王宁利 段安丽 |
| 作者单位： | 中国北京市,首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科学与视觉科学重点实验室,中国北京市,首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科学与视觉科学重点实验室,中国北京市，首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科研究所 北京市眼科学与视觉科学重点实验室,中国北京市，首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科研究所 北京市眼科学与视觉科学重点实验室,中国北京市,首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科学与视觉科学重点实验室 |
| 基金项目： | 首都卫生发展科研专项(No.首发2020-2-2053) |
| 摘 要： | 目的：评估空气填充联合内界膜翻转及自体血治疗伴有后巩膜葡萄肿的高度近视黄斑裂孔性视网膜脱离(MHRD)的疗效。 方法：回顾性非对照研究分析高度近视眼MHRD患者的治疗效果。玻璃体切割术中使用曲安奈德染色清除玻璃体后皮质，内界膜翻转后应用自体血固定翻转的内界膜后空气填充。记录术后黄斑裂孔闭合率、视网膜复位率及术后最佳矫正视力(BCVA)。 结果：研究共纳入高度近视MHRD患者24例24眼。患者随访至少6mo，平均13.58±7.00mo。末次随访时21眼(88%)黄斑裂孔闭合，20眼(83%)视网膜复位。其中17眼(71%)黄斑裂孔闭合且视网膜复位，3眼(13%)黄斑裂孔未闭合但视网膜复位，4眼(17%)黄斑裂孔闭合但仍有视网膜下液。所有病例无需接受二次玻璃体切割手术。末次随访BCVA(LogMAR)较术前显著提高(0.65±0.34 vs 1.36±0.49，P<0.001)。12眼(50%)的BCVA提高大于等于2行。 结论：玻璃体切割术联合内界膜翻转、自体血及空气填充是治疗高度近视眼MHRD的有效方法。 |
| 关 键 词： | 内界膜 黄斑裂孔 高度近视 视网膜脱离 玻璃体切割 |
| 收稿时间： | 2021/12/16 0:00:00 |
| 修稿时间： | 2022/3/4 0:00:00 |
Air tamponade with inverted internal limiting membrane flap technique for macular hole retinal detachment in high myopia with posterior staphyloma |
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| Hai-Cheng She,Yue Qi,Zi-Bing Jin,Ning-Li Wang and An-Li Duan.Air tamponade with inverted internal limiting membrane flap technique for macular hole retinal detachment in high myopia with posterior staphyloma[J].International Journal of Ophthalmology,2022,22(4):536-540. | |
| Authors: | Hai-Cheng She Yue Qi Zi-Bing Jin Ning-Li Wang and An-Li Duan |
| Institution: | Beijing Tongren Eye Center;Beijing Tongren Hospital, Capital Medical University;Beijing Ophthalmology and Visual Science Key Lab, Beijing 100730, China,Beijing Tongren Eye Center;Beijing Tongren Hospital, Capital Medical University;Beijing Ophthalmology and Visual Science Key Lab, Beijing 100730, China,Beijing Institute of Ophthalmology; Beijing Tongren Eye Center; Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology and Visual Science Key Lab, Beijing 100730, China,Beijing Institute of Ophthalmology; Beijing Tongren Eye Center; Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology and Visual Science Key Lab, Beijing 100730, China and Beijing Tongren Eye Center;Beijing Tongren Hospital, Capital Medical University;Beijing Ophthalmology and Visual Science Key Lab, Beijing 100730, China |
| Abstract: | AIM: To evaluate the effect of vitrectomy with inverted internal limiting membrane(ILM)flap technique and air tamponade in high myopic eyes with macular hole retinal detachment(MHRD). METHODS: A retrospective, noncomparative study of high myopia patients with MHRD was conducted. In all cases, triamcinolone acetonide was used to visualize the vitreous during vitrectomy. After ILM was inverted, a venous blood clot was placed on the inverted ILM flap and air was used as tamponade. Macular hole closure rate, retinal reattachment rate, and postoperative best-corrected visual acuity(BCVA)were assessed after the surgery. RESULTS: Twenty-four eyes of 24 high myopia patients with MHRD were included in this study. The patients were followed up for at least 6mo, averaging 13.58±7.00mo. At last follow up,macular hole(MH)was closed in 21 eyes(88%)and retina was reattached in 20 eyes(83%). Seventeen eyes(71%)had both complete MH closure and retinal reattachment. Three eyes(13%)had complete reattached retina with unclosed MH, while 4 eyes(17%)had persistent subretinal fluid with closed MH. No additional pars plana vitrectomy(PPV)was performed. BCVA(LogMAR)was significantly improved at last follow up(0.65±0.34 vs 1.36±0.49, P<0.001). An improvement in BCVA of 2 or more lines was achieved in 12 eyes(50%). CONCLUSION:Vitrectomy combined with inverted ILM flap, autologous blood transplantation and air tamponate is an effective treatment for MHRD in myopic eyes. |
| Keywords: | internal limiting membrane macular hole high myopia retinal detachment vitrectomy |
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