黄斑区内界膜剥除联合38G套管针应用治疗黄斑区视网膜下全氟萘烷残留的疗效

目的：观察黄斑区内界膜(ILM)剥除联合38G套管针应用治疗黄斑区视网膜下全氟萘烷残留的疗效。
　　方法：选取来自厦门眼科中心2008-01/2013-10期间的29例29眼视网膜复位良好、但黄斑区视网膜下全氟萘烷残留的患者,分为A组、B组。 A组14例14眼,取出硅油后,直接以38 G套管针吸除黄斑区视网膜下全氟萘烷液体,术闭填充过滤空气。 B组15例15眼,取出硅油后,染色并完整剥除黄斑区ILM,范围约4PD,以38G套管针吸除黄斑区视网膜下全氟萘烷液体,术闭填充过滤空气。所有病例如在术后1 wk复查OCT发现黄斑裂孔形成者,均再行气液交换,填充16% C3 F8气体。观察两组病例术后4,8,24 wk最佳矫正视力( BCVA )变化,复查OCT观察黄斑区视网膜下全氟萘烷液体有无残留、有无黄斑裂孔形成及黄斑区形态变化等。
　　结果：两组术后 4, 8, 24 wk 的 BCVA 均有提高, B 组的BCVA提高值优于A组( P<0.05)。 A 组术后24 wk 有7例(50%)黄斑裂孔形成,黄斑区无全氟萘烷残留。 B组术后24 wk 1例(7%)黄斑裂孔形成,黄斑区无全氟萘烷残留。
　　结论：黄斑区内界膜剥除联合38 G套管针应用治疗黄斑区视网膜下全氟萘烷残留的方法可以彻底吸除黄斑区视网膜下全氟萘烷,较少出现黄斑裂孔,该方法安全、有效、微创,有效保护了黄斑区视功能。

Effect of the perfluorodecalin residue on macular subretinal treated by internal limiting membrane peeling combined with 38G casing needle

AIM: To observe the effect of the treatment to the perfluorodecalin residue on macular subretinal by internal limiting membrane(ILM)peeling combined with 38G casing needle.

METHODS: Twenty-nine cases(29 eyes)of retinal reattachment and with perfluorodecalin residual on the macular subretinal, selected in Xiamen Eye Center from January 2008 to October 2013, were divided into group A(14 cases, 14 eyes)and group B(15 cases, 15 eyes)randomly. In group A, after removal of silicone oil, perfluorodecalin liquids at the macular subretinal directly were aspirated by 38G casing needle. In group B, after removal of silicone oil, ILM was dyed and peeled completely to the range of 4PD approximately. Then the perfluorodecalin liquids at the macular subretinal were aspirated by 38G casing needle. All cases of both groups were filled with filtered air. After 1wk, the case with macular hole found by OCT was exchanged by air-fluid and filled with 16% C₃F₈. The best corrected visual acuity(BCVA)of two groups of patients was observed after 4, 8, 24wk. OCT was reviewed to observe whether there were perfluorodecalin residue on the macular subretinal, formation of macular hole and macular morphological changes, retinal detachment.

RESULTS: BCVA was improved in both groups after 4, 8, 24wk. And the value of BCVA improvedin group B was better than that in group A(P<0.05). There were 7 cases(50%)with macular hole in group A and 1 case(7%)with macular hole in group B at 24wk after operation. In both groups, there were no perfluorodecalin residual on the macular and retinal detachment at 24wk after surgery.

CONCLUSION: ILM peeling combined with 38G casing needle can aspirate completely the perfluorodecalin residual on macular. There were not caused macular hole and retinal detachment. This method is an safe, effective and minimally invasive surgical technique to protect the macular function.