光学相干断层扫描对黄斑"白孔"性视网膜脱离的疗效评价

目的使用光学相干断层扫描(opticalcoherencetomography,OCT)观察用不同眼内填充物(C3F8气体或硅油)治疗伴随视网膜脱离的高度近视性黄斑“白孔”的预后。方法对由于高度近视性黄斑“白孔”而发生视网膜脱离,并接受玻璃体切除联合眼内填充物注入术的29眼(C3F8填充的10眼、硅油填充的19眼)进行随访,使用OCT评价黄斑孔的愈合情况。结果经OCT检查证实,19眼经玻璃体切除联合硅油填充术治疗后黄斑裂孔成功闭合,其中8眼是在以C3F8填充后未愈,而再次行玻璃体切除手术并改用硅油填充治疗获成功。10只患眼以玻璃体切除联合C3F8填充手术后视网膜复位,但8只患眼黄斑孔未闭合。结论使用OCT检查可以帮助评价手术疗效。适当采用玻璃体切除联合眼内硅油填充手术有助于提高黄斑裂孔的闭合成功率。

Anatomical evaluation of the effects of different tamponades on retinal detachment secondary to macular holes in high myopia using optical coherence tomography

Objective To evaluate the effects of different tamponades used for retinal detachment secondary to macular holes in high myopia using optical coherence tomography (OCT).Methods OCT was used to follow the changes in the macular structure of 29 high myopia eyes, which had been diagnosed as having retinal detachment secondary to macular holes, after treatment with vitrectomies combined with different tamponades (10 eyes with C3F8, 19 eyes with silicone oil).Results OCT confirmed that the macular holes successfully closed in all of the 19 eyes filled with silicone oil. Eight of these eyes had previously been treated with C3F8. Because the redettachment of the retina was secondary to the macular holes, these patients accepted the silicone oil as tamponades. The retinas of 10 eyes filled with C3F8 were attached, but OCT examination found that 8 eyes did not achieve complete closure of the macular holes.Conclusion OCT can objectively evaluate the anatomical effects of surgery. Properly chosen silicone oil as the tamponade can improve the surgical outcome.