后巩膜收缩术治疗病理性近视黄斑劈裂

目的：评估后巩膜收缩术对病理性近视黄斑劈裂的治疗效果。方法：回顾性研究。选取2014年12月 至2017年04月在南京市第一医院眼科行后巩膜收缩术的病理性近视黄斑劈裂患者24例（45眼），观察手术前后患者的最佳矫正视力、眼轴长度、屈光度、黄斑区视网膜劈裂高度的状况与手术并发症。对相关计量资料进行重复测量方差分析。结果：患者术前，术后1个月、3个月、6个月及12个月的黄斑区视网膜劈裂高度分别为（494±31）、（299±24）、（256±24）、（200±22）、（168±25）μm，术后各时间点与术前比较差异有统计学意义（均P<0.05）。患者术后1、3、6个月眼轴长度分别为（28.6±2.1）、（28.9±2.0）、（29.3±2.0）mm，与术前（30.5±2.2）mm]相比差异有统计学意义（P<0.05），术后12个月眼轴（29.8±2.1）mm，与术前相比差异无统计学意义（P>0.05）。患者术后1个月、3个月的屈光度分别为（-15.14±5.16）D、（-15.64±5.05）D，与术前（-17.33±7.43）D]相比差异有统计学意义（P=0.013、0.048），术后6、12个月的屈光度分别为（-15.96±4.97）D、（-17.05±5.10）D，与术前相比差异无统计学意义（P>0.05）。患者最佳矫正视力差异无统计学意义（P>0.05）。结论：针对病理性近视黄斑劈裂伴或不伴视网膜脱离的治疗，后巩膜收缩术的安全性和可行性较好。

Clinical Observation of Posterior Scleral Buckling in the Treatment of Pathological Myopia with Macular Splitting

Objective: To investigate the therapeutic effect of posterior scleral contraction on macular splitting in pathologic myopia. Methods: This was a retrospective study. Posterior scleral contraction was performed on 45 eyes (24 cases) with macular cleft palate from December 2014 to April 2017 from Nanjing First Hospital. Outcomes, including BCVA, ocular axial length, refractive error, central foveal thickness and surgical complications, were observed at the preoperative baseline and postoperatively 1, 3, 6 and 12 months. Data were performed by repeated measures analysis of variance. Results: Central foveal thickness preoperatively and postoperatively at 1, 3, 6 and 12 months was 494±31, 299±24, 256±24, 200±22, 168±25 μm, respectively. Both decreased significantly compared with preoperative measurements(P<0.05). Axial length postoperatively at 1, 3, 6 months was 28.6±2.1, 28.9±2.0, 29.3±2.0 mm, which was a statistically significant compared to the baseline 30.5±2.2 mm (P<0.05). Axial length at 12 months was 29.8±2.1 mm, which was no statistically significant difference compared to the baseline (P>0.05). Refractive errors at 1 and 3 months were -15.14±5.16 D and -15.64±5.05 D, which was a statistically significant diminishment compared to the baseline (-17.33±7.43 D)(P<0.05). Refractive errors at 6 and 12 months were -15.96±4.97 D and -17.05±5.10 D, which was no statistically significant difference compared to the baseline (P>0.05). There was no statistically significant difference of BCVA between the preoperative and the postoperative (P>0.05). Conclusions: Posterior scleral contraction might become a safe and effective way to treat macular cleavage in high myopia with or without retinal detachment.