Macular,papillary and peripapillary perfusion densities measured with optical coherence tomography angiography in primary open angle glaucoma and pseudoexfoliation glaucoma

Graefe's Archive for Clinical and Experimental Ophthalmology - To compare the blood flow situation in primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (PXG) using optical...     

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

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。     

光学相干断层扫描技术在原发性开角型青光眼早期诊断中的应用

目的：探讨利用光学相干断层扫描技术(optical coherence tomography, OCT)测量视乳头旁视网膜神经纤维层(retinal nerve fiber layer, RNFL)厚度、视盘形态和黄斑区视网膜厚度在原发性开角型青光眼(primary open angle glaucoma, POAG)早期诊断中的应用价值。

方法：选取2016-01/2017-06本院收治的POAG 患者65例85眼作为研究组, 随机选取同期在本院进行身体检查的健康者52例78眼作为对照组,采用OCT测量视乳头旁RNFL厚度、黄斑区视网膜厚度和视盘参数包括杯/盘比(C/D)、视杯面积(cup area, CA)、视杯容积(cup volume, CV)、视盘面积(disc area, DA)、盘沿面积(rim area, RA)和盘沿容积(rim volume, RV),并对检测结果进行比较分析。

结果：研究组视乳头旁RNFL厚度在上方、下方、颞侧、鼻侧和均值均明显小于对照组,差异有统计学意义(P<0.001); 研究组CA、CV、C/D明显高于正常对照组,差异有统计学意义(P<0.001),而DA、RV明显小于正常对照组,差异有统计学意义(P<0.001),DA则略小于正常对照组,差异无统计学意义(P>0.05)。研究组黄斑区视网膜厚度在上方、下方、颞侧、鼻侧均明显小于对照组,差异有统计学意义(P<0.001)。

结论：OCT能够定量客观检测RNFL厚度、黄斑区视网膜厚度和视盘参数,这有助于POAG的早期诊断。     

玻璃体切除术联合内界膜剥除治疗特发性黄斑裂孔

目的:探讨玻璃体切除术联合内界膜剥除治疗特发性黄斑裂孔的疗效。方法:对93例93眼特发性黄斑裂孔患者行玻璃体切除联合内界膜剥除,气液交换,眼内填充C3F8。术后观察术眼视力及OCT了解黄斑裂孔变化。结果:特发性黄斑裂孔患者93例中裂孔完全愈合89例(96%),4例裂孔未闭,患者拒绝再次手术。绝大多数患者术后视力提高。结论:玻璃体切除联合内界膜剥除是治疗特发性黄斑裂孔的有效方法,能使绝大多数患者的裂孔得到解剖愈合,视力提高。     

玻璃体切除联合内界膜剥除手术治疗特发性黄斑裂孔

目的:探讨玻璃体切除联合内界膜撕除手术对黄斑裂孔的疗效。方法:从我院眼科玻璃体切除手术治疗患者中提出有详细临床、手术及随访资料的黄斑裂孔患者资料46例。结果:术后95.6%患者解剖复位,裂孔封闭;1例视网膜复位、裂孔未闭;1例裂孔未闭,视网膜脱离在1mo内复发。结论:经玻璃体切除联合内界膜撕除手术绝大部分患者得到解剖治愈,视力提高     

玻璃体切除联合内界膜剥离术治疗高度近视黄斑裂孔的疗效

目的：比较经睫状体平坦部玻璃体切除术( pars plana vitrectomy, PPV )与 PPV 联合内界膜剥离术( internal limiting membrane peeling,ILMP)治疗高度近视黄斑裂孔的临床效果。
　　方法：回顾性分析高度近视黄斑裂孔患者(伴或不伴黄斑裂孔性视网膜脱离)33例36眼的病例资料。根据手术方式不同,分为Ⅰ组和Ⅱ组。Ⅰ组15眼行玻璃体切除术(不剥离内界膜);Ⅱ组21眼行玻璃体切除联合内界膜剥离术,术中根据患者病情不同,给予不同的辅助方式,如行硅油填充、C3 F8填充、光凝、冷凝等。术后随访3~12mo,以术后最佳矫正视力( best corrected visual acuity,BCVA)、裂孔闭合及视网膜复位情况作为疗效观察指标,并将两组数据进行统计学分析。
　　结果：Ⅰ组15眼术后最佳矫正视力( LogMAR )较术前平均提高0.167,差异有统计学意义(t=2.46,P=0.027);Ⅱ组术后最佳矫正视力( LogMAR )较术前平均提高0 .456,差异有统计学意义(t=6.753,P=0.000);两组间术后视力提高程度比较,差异有统计学意义( t=-2.943, P=0.006)。Ⅰ组患者黄斑裂孔闭合率46.67%;Ⅱ组患者黄斑裂孔闭合率85 .71%;比较两组术后裂孔闭合率,差异有统计学意义(χ2=6.287,P=0.025)。Ⅰ组视网膜最终复位率91 .67%。Ⅱ组视网膜最终复位率94 .73%,比较两组患者视网膜复位情况,差异无统计学意义(χ2=0.856,P=0.418)。
　　结论：玻璃体切除联合内界膜剥离术可以显著提高高度近视黄斑裂孔的闭合率和术后视力,但对于视网膜的复位率较不剥膜者无明显区别。     

特发性黄斑裂孔OCT影像与术后早期视力恢复的相关性研究

目的 研究特发性黄斑裂孔(idiopathic macular holes,IMH)患者术前光学相干断层扫描技术(optical coherence tomography,OCT)测量的相关参数与术后早期视力恢复的相关性.方法 收集24例(25眼)IMH患者,均行玻璃体切割+内界膜剥离+玻璃体内注气术,术前、术后12周均行最佳矫正视力(best corrected visual acuity,BCVA)检查,术前1周内OCT影像上直接测量裂孔最大高度,通过Image-Pro Plus 6.0软件测量黄斑裂孔最小径、基底径及外界膜光感受器断裂点与视网膜色素上皮层的最大垂直高度,并计算黄斑孔指数(macular hole index,MHI)、牵拉孔指数(tractional hole index,THI)、黄斑孔指数’(macular hole index’,MHI’)及牵拉孔指数’(tractional hole index’,THI’),应用SPSS 22.0软件包进行Spearman相关性分析,得出各参数与术后12周时BCVA的相关性,受试者工作特征曲线拟合分析得出MHI、THI、MHI’、THI’界值.结果 IMH患者术后12周BCVA较术前明显提高且差异有统计学意义(P=0.000).相关性分析结果表明:术后12周BCVA与术前MHI、THI、MHI’、THI’具有相关性(均为P＜0.05).MHI ≥0.705组术后12周时BCVA平均为0.297,好于MHI＜0.705组的0.103(P=0.023);THI≥1.425组术后12周时BCVA平均为0.288,好于THI＜1.425组的0.163(P =0.001).结论 THI≥1.425或MHI ≥0.705者术后12周时能获得较好的BCVA,可作为预测IMH患者术后早期视力恢复情况的指标.     

特发性黄斑裂孔研究进展

特发性黄斑裂孔(idiopathic macular hole,IMH)是指无明确原因发生于黄斑区域的视网膜全层缺损。随着玻璃体切割技术的进步和对联合内界膜剥除的研究,特发性黄斑裂孔的治疗技术进一步成熟。本文从IMH的发病机制、术前预后评估及手术治疗相关等方面的进展作一综述。     

Optical coherence tomography in the evaluation of vitreoretinal disorders of the macula in highly myopic eyes

A higher incidence of vitreoretinal disorders is found in highly myopic eyes; however, in the same eyes, several factors contribute to make visualization of the macular area most difficult. As a consequence, vitreoretinal macular disorders are often misdiagnosed in these eyes. Ocular coherence tomography (OCT) has proven to be an invaluable technique for the evaluation of the microscopic features of the macula in highly myopic eyes, allowing us to identify which patients are at higher risk of complications, before surgical or parasurgical procedures are embarked upon. Several macular disorders, characteristic of highly myopic eyes, are described.     

吲哚菁绿染色与无染色视网膜内界膜剥除治疗黄斑裂孔的疗效观察

目的 观察玻璃体切割术中使用吲哚菁绿染色与无染色内界膜剥除术治疗特发性黄斑裂孔的疗效及并发症.方法 回顾性分析2006年1月至2009年3月于我院眼科行玻璃体切割联合视网膜内界膜剥除术治疗的特发性黄斑裂孔患者共计88例94眼,其中染色组55例59眼,术中使用吲哚菁绿辅助剥除内界膜;无染色组33例35眼,术中不使用染色剂.比较两组术后黄斑区视网膜最大厚度、黄斑裂孔闭合及视网膜复位情况,最佳矫正视力提高情况,剥除视网膜内界膜手术时间,mfERG变化情况.结果 随访至术后12个月时,两组患者黄斑裂孔均完全闭合、视网膜均复位.视网膜最大厚度检测结果显示,染色组与无染色组手术前后厚度的差值相比差异无统计学意义(P＞0.05).染色组术后最佳矫正视力提高2行及以上者40眼(67.8％),无染色组28眼(80.0％);染色组内界膜剥除手术时间为(235.0±9.1)s,无染色组为(168.0±7.4)s,上述两项指标两组比较差异均有统计学意义(均为P＜0.05).两组mfERG一阶函数的1环和2环P1波反应密度均较术前明显增加,与术前相比差异均有统计学意义(均为P＜0.05),但染色组增加幅度小于无染色组,两组之间比较差异有统计学意义(P＜0.05).结论 与既往应用吲哚菁绿染色行视网膜内界膜剥除术相比较,不染色行视网膜内界膜剥除术也能达到使黄斑裂孔闭合、视网膜脱离复位的目的,且视功能恢复程度更好,手术用时更少,同时避免了染色剂所致的视网膜毒性,适宜广泛应用.     

玻璃体切割联合内界膜填塞及鼠神经生长因子注射治疗大直径特发性黄斑裂孔

目的：观察玻璃体切割术(PPV)联合内界膜(ILM)填塞及鼠神经生长因子(NGF)注射治疗大直径特发性黄斑裂孔(IMH)的临床疗效。

方法：回顾性病例研究。选取2018-05/2020-05在南京医科大学眼科医院检查确诊并行PPV联合ILM填塞及鼠NGF注射的大直径IMH患者16例16眼纳入研究。所有入组患者均接受经睫状体扁平部三通道23G PPV联合ILM填塞及鼠NGF注射治疗。观察术后最佳矫正视力\〖BCVA(LogMAR)\〗、裂孔闭合率、分析黄斑裂孔闭合的OCT分型、中心凹外层结构包括椭圆体带(EZ)、外界膜(ELM)的连续性及术后并发症等。

结果：患者术前BCVA为1.15±0.21,术后3、6mo BCVA分别为1.02±0.19、0.87±0.24(F=34.966,P<0.01); 术后3、6mo BCVA较术前均有改善(P<0.01),且术后6mo BCVA较术后3mo改善(P<0.01)。术后患者裂孔闭合率为100%,OCT所显示的闭合形态中,11眼为U型闭合(69%); 3眼为V型闭合(19%); 2眼为不规则闭合(13%)。术后6mo,U型、V型及不规则闭合组眼的BCVA分别为0.75±0.18、1.1±0.19、1.20±0.00(F=6.937, P<0.01),其中U型闭合组的BCVA恢复明显优于V型闭合组和不规则闭合组(P=0.027、0.007)。术后6mo,U形闭合组中有10眼(91%)ELM恢复连续性、7眼(64%)EZ恢复连续性,V型闭合组中有2眼(67%)ELM恢复连续性、1眼(33%)EZ恢复连续性,不规则闭合眼中未见ELM、EZ连续性恢复(P<0.05)。随访期间未发现眼部及全身并发症。

结论：PPV联合ILM填塞及鼠NGF注射治疗对大直径IMH安全有效,NGF与ILM的协同作用可促进裂孔的闭合,有利于视网膜光感受器细胞的完整性恢复及术后视功能的改善。     

Displacement of the retina after idiopathic macular hole surgery with different internal limiting membrane peeling patterns

AIM: To explore retinal displacement after surgical treatment for idiopathic macular hole (IMH) with different internal limiting membrane (ILM) peeling patterns. METHODS: Totally 22 eyes from 20 patients with IMH were randomly allocated into two groups, N-T group (11 eyes) and T-N group (11 eyes). For patients in N-T group, ILM was peeled off from nasal to temporal retina. For patients in T-N group, ILM was peeled off from temporal to nasal retina. Preoperative, postoperative 1, 3, and 6mo, autofluorescence fundus images were collected for manual measurement of distances of fixed nasal (N), temporal (T), superior (S), and inferior (I) retinal points (bifurcation or crossing of retinal vessels) around the macula to the optic disc (OD). These were respectively defined as N-OD, T-OD, S-OD, and I-OD. The retinal displacement, macular hole closure rate, and best corrected visual acuity (BCVA) were compared between the two groups after surgery. RESULTS: At postoperative 1, 3, and 6mo, the macula slipped toward the OD, manifested by the decreased T-OD, N-OD, S-OD, and I-OD (P<0.05). No significant difference was found in the T-OD, N-OD, S-OD, and I-OD between N-T group and T-N group. IMH closure rate was 100% both in N-T group and T-N group. There was no significant difference in BCVA between two groups (P<0.05). CONCLUSION: The macula slips toward the OD after successful macular hole surgery. The two different ILM peeling pattern show similar visual outcome and retinal displacement, which means ILM peeling directions are not the influencing factor of postoperative retinal displacement.     

应用25G系统玻璃体切除术联合内界膜剥离治疗特发性黄斑孔

目的探讨应用25G系统玻璃体切除术联合内界膜剥离治疗特发性黄斑孔的手术效果。方法对10例（10眼）特发性黄斑孔行25G系统玻璃体切除术联合内界膜剥离,气液交换,眼内充填C3F8。术后观察视力,并进行OCT检查了解黄斑孔封闭情况。结果10例（10眼）黄斑孔均闭合。随访1～6个月,2眼视力未提高,8眼视力提高1～3行,10眼均未见复发。结论玻璃体切除术联合内界膜剥离治疗特发性黄斑孔是有效的;25GTSV应用于黄斑孔的手术治疗具有手术时间短、创伤小及术后恢复怏等优点。     

玻璃体切除联合内界膜剥除翻转填塞治疗特发性黄斑裂孔的短期疗效及影响因素

目的 观察玻璃体切除联合内界膜剥除翻转填塞治疗特发性黄斑裂孔的疗效和预后影响因素。设计 回顾性病例系列。研究对象 特发性黄斑裂孔患者36例（37眼）。方法 所有患者行玻璃体切除联合内界膜剥除翻转填塞手术。术后随访时间4个月。观察眼压、最佳矫正视力（best-corrected visual acuity, BCVA）、裂隙灯、间接检眼镜、眼轴长度（axial length, AL）、黄斑裂孔直径;频域相干光断层扫描（spectral domain optical coherence tomography, SD-OCT）测量术前及术后黄斑区视网膜各层厚度,包括视网膜神经纤维层（retinal nerve fiber layer, RNFL）、视网膜神经节细胞层（ganglion cell layer, GCL）、内丛状层（inner plexiform layer, IPL）、内核层（inner nuclear layer, INL）、外丛状层（outer plexiform layer, OPL）、外核层（outer nuclear layer, ONL）、视网膜色素上皮层（retinal pigment epithelium, RPE）;Spearman相关性分析术后BCVA与术前BCVA、AL、年龄、黄斑裂孔大小等的关系。主要指标 裂孔闭合率,BCVA,视网膜厚度。结果 术后黄斑裂孔闭合率100%。术前、术后平均BCVA （LogMRA）分别为1.23±0.64和0.28±0.17（P<0.05）。SD-OCT测量术后黄斑区鼻侧和颞侧的RNFL、GCL、IPL、INL厚度明显变薄(P均<0.05);黄斑区鼻侧和颞侧OPL、ONL、RPE厚度变化无统计学意义（P均>0.05）。术后BCVA与术前BCVA（r=0.641）、黄斑裂孔最小直径（r=0.662）、白内障手术（r=0.438）、黄斑区鼻侧RNFL厚度变化（r=0.349）、黄斑区鼻侧IPL厚度变化（r=0.383）有相关性（P均<0.05）。结论 玻璃体切除联合内界膜剥除翻转填塞治疗黄斑裂孔能改善术后BCVA。术前BCVA、黄斑裂孔最小直径、白内障手术、黄斑区鼻侧RNFL厚度变化、黄斑区鼻侧IPL厚度变化是影响术后BCVA的因素。     

Optical coherence tomography angiography measured capillary density in the normal and glaucoma eyes

Purpose

To compare the diagnostic ability of optical coherence tomography angiography (OCT-A) derived radial peripapillary capillary (RPC) measured capillary density (CD) and inside the optic nerve head (ONH) CD measurements to differentiate between the normal and primary open angle glaucoma (POAG) eyes.

玻璃体切割联合内界膜覆盖术治疗高度近视黄斑裂孔视网膜脱离

目的:比较玻璃体切割联合内界膜剥除术或内界膜覆盖术治疗高度近视黄斑裂孔视网膜脱离(MHRD)的疗效。方法:回顾性临床研究。选取2020-01/2021-06于我院行玻璃体切割联合内界膜剥除术或内界膜覆盖术治疗的高度近视MHRD患者38例38眼,根据手术方式分为对照组(行玻璃体切割联合内界膜剥除术)和观察组(行玻璃体切割联合内界膜覆盖术)。随访至术后3mo,比较两组患者手术时间、最佳矫正视力(BCVA)、黄斑裂孔闭合和视网膜复位情况。结果:两组患者手术时间无差异(30.71±4.55min vs 35.20±5.44min,P=0.384)。末次随访时,两组患者BCVA均较术前明显改善(均P<0.01),但两组患者BCVA(LogMAR)无差异(1.39±0.24 vs 1.46±0.27,P=0.700);观察组患者黄斑裂孔闭合率高于对照组(100%vs 71%,P=0.024),但两组患者视网膜再脱离率比较无差异(0 vs 10%,P=0.492)。结论:两种手术方式均可改善患者视力,但玻璃体切割联合内界膜覆盖术后黄斑裂孔闭合率更高。     

Central corneal thickness measurements in patients with normal tension glaucoma, primary open angle glaucoma, pseudoexfoliation glaucoma, or ocular hypertension.

BACKGROUND/AIMS: Recent studies have revealed patients with ocular hypertension to have thicker than normal central corneas and those with normal tension glaucoma to have thinner than normal ones, as determined by ultrasonic pachymetry. Since corneal thickness measurements and applanation tonometric estimates of intraocular pressure (IOP) correlate positively, monitoring of the former parameter have served as the basis for adjusting readings pertaining to the latter, with the consequence that many patients have had to be reclassified. With a view to validating these pachymetric studies, the central corneal thickness was determined in patients with normal tension glaucoma, primary open angle glaucoma, pseudoexfoliation glaucoma, or ocular hypertension, as well as that of normal subjects, using optical low coherence reflectometry, which is a new and more precise method than ultrasonic pachymetry. METHODS: 34 patients with normal tension glaucoma, 20 with primary open angle glaucoma, 13 with pseudoexfoliation glaucoma, and 12 with ocular hypertension, together with 21 control subjects, were included in this observational, concurrent case-control study. One eye per individual was randomly selected for investigation. IOP was measured by Goldmann applanation tonometry and central corneal thickness by optical low coherence reflectometry. RESULTS: Central corneal thickness was significantly higher (p < or =0.001) in patients with ocular hypertension than in normal individuals or in subjects with either normal tension glaucoma, primary open angle glaucoma, or pseudoexfoliation glaucoma, there being no significant differences between the latter four groups. Patients with ocular hypertension were also significantly younger (p < or =0.003) than those within any of the three glaucomatous groups. CONCLUSION: This study confirms that a significant number of patients with ocular hypertension have normal IOPs after the appropriate adjustments have been made for deviations from normal in their central corneal thickness. The accurate measurement of this latter parameter is important not only for individual patient care, in permitting more precise estimations of IOP, but also for clinical studies, in assuring a more reliable classification of subjects.     

Evaluation of retinal functional changes after macular hole surgery using heavy brilliant blue G dye for internal limiting membrane staining: A prospective,single blind,randomized controlled trial

Purpose:To evaluate retinal functional changes after idiopathic macular hole (MH) surgery using heavy brilliant blue G (hBBG) dye for internal limiting membrane (ILM) staining.Methods:Forty-four eyes with idiopathic MH were randomized into two groups – 24 eyes undergoing vitrectomy with ILM peeling using hBBG staining and 20 eyes without staining; anatomical and functional status (with microperimetry (MP)) at baseline and during postoperative follow-up were noted and compared.Results:All eyes had closure of MH postoperatively and overall baseline MP indices (average threshold, AT; foveal sensitivity, FS) improved significantly at 6 weeks and 6 months of follow-up. AT and FS showed significant improvement at 6 weeks and 6 months from baseline in both individual groups (P < 0.001). Intergroup comparison showed that there was no statistically significant difference in AT and FS values at any point of time (baseline, 6 weeks, 6 months) between staining and no-stain group. No eyes in our cohort had any unexplained visual loss.Conclusion:Functional parameters of macula improved significantly after successful MH surgery using hBBG for staining the ILM.     

Surgical management of retinal detachment resulting from macular hole in a setting of high myopia

 PURPOSE:To evaluate the anatomical and visual outcomes of pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling and use of retinal tamponade for retinal detachments resulting from macular hole (MHRD) in highly myopic eyes. METHODS: Twenty-nine highly myopic patients (29 eyes) underwent PPV with ILM peeling and retinal tamponade for MHRD were enrolled. Demographics and best-corrected visual acuity (BCVA) were measured preoperatively and at final follow-up. Anatomical success and macular hole closure were analyzed. RESULTS:Patients' mean age of patients was 58.7 ± 10.6 years, mean follow-up was 11.7 ± 7.4 months. Twenty three eyes (23/26, 88.5%) undergoing primary PPV combined with ILM peeling had successful initial retinal reattachment, including 19 eyes (19/19, 100%) with silicone oil tamponade and in 4 eyes (4/7, 57.1%) with sulfur hexafluoride (C3F8) tamponade. Overall anatomical success was achieved in 27 eyes (27/29, 93.1%). The macular hole closure was observed in 17 eyes (17/26, 65.4%) with final anatomical success. Compared to preoperative BCVA, the mean postoperative BCVA in the eyes with anatomical success was significantly improved (P = 0.007, Wilcoxon signed rank test). CONCLUSION:As a primary or secondary procedure, PPV combined with ILM peeling and usage of retinal tamponade serves as an effective method for MHRD in highly myopic eyes.     

玻璃体切除术联合不同填充物治疗特发性黄斑裂孔的比较

目的:比较玻璃体切除内界膜剥除术联合C3F8与消毒空气填充治疗特发性黄斑裂孔(IMH)的效果.方法:连续选取2011-01/2016-01就诊于我院的IMH孔径≤600μm的患者51例51眼,接受我院同一医师独立完成的玻璃体切除内界膜剥除联合玻璃体腔内填充术,随机分为A、B两组.A组27例为16% C3F8 填充组,B组24例为消毒空气填充组.所有患者在术后1wk,1、3、6mo复查.比较两组患者末次复查时裂孔的闭合率(黄斑裂孔闭合率按照孔径≤200、>200~400、>400~600μm区间进行比较)、裂孔闭合形态、俯卧时间、最佳矫正视力(BCVA)、视物变形的改善情况以及术后白内障进展情况.结果:在各孔径区间内,两组患者裂孔闭合率差异无统计学意义(P>0.05);两组患者术后黄斑裂孔闭合形态差异无统计学意义(P>0.05);B组俯卧位时间较A组明显缩短,差异有统计学意义(P<0.01);两组患者术后BCVA较术前均提高,差异有统计学意义(P<0.05),但两组间BCVA比较差异无统计学意义(P>0.05);两组患者视物变形有不同程度改善,两组间比较差异无统计学意义(P>0.05);B组术后白内障进展率较A组降低,差异无统计学意义(P>0.05).结论:治疗孔径≤600μm的特发性黄斑孔患者,与C3F8 填充组相比,消毒空气填充组在获得同样较高的裂孔闭合率、良好的裂孔闭合形态以及视功能改善的同时,也明显缩短了俯卧时间,降低了术后长期俯卧位而诱发全身疾病的风险.