玻璃体切割联合硅油填充与C3F8填充治疗高度近视黄斑裂孔视网膜脱离临床效果比较

背景 高度近视黄斑裂孔视网膜脱离(MHRD)可造成严重的视力下降,经睫状体平坦部的玻璃体切割术联合眼内填充术已应用于该病的临床治疗,目前常用的眼内填充物包括硅油及可膨胀性气体C3F8,两种填充物的效果比较仍缺少相关研究证据. 目的 评价玻璃体切割联合硅油填充与C3F8填充治疗高度近视黄斑裂孔视网膜脱离的手术效果.方法 采用回顾性病例对照设计.对采用玻璃体切割联合眼内填充术治疗的51例高度近视MHRD患者,根据术中眼内填充物的不同将患者分为硅油填充组和C3F8填充组,两组患者基线资料一致.对两组术眼术后的最佳矫正视力(BCVA)、视网膜复位率、黄斑裂孔闭合情况及视网膜脱离复发率进行分析和比较. 结果 两组患者术前视力差异无统计学意义(U=266.000,P=0.286),基线视力一致,术中不同眼内填充物治疗后视力差异亦无统计学意义(U=205.000,P=0.029);应用硅油填充及C3F8填充患者BCVA术后与术前相比均有显著提高,差异均有统计学意义(Z=-2.729,P=0.006;Z=-3.273,P=0.001),两组患者术后视网膜脱离发生率及黄斑裂孔解剖闭合率差异均无统计学意义(P=0.894、1.000).患者除白内障外无其他并发症发生. 结论 应用C3F8填充治疗高度近视MHRD与硅油填充治疗效果相同,且均安全、有效.

An analysis of the efficacy of vitreous surgery combined with silicone oil or C3F8 tamponade for patient with macular hole retinal detachment in high myopic eyes

Background Macular hole retinal detachment （MHRD） causes severe decrease of vision. Pars plana vitrectomy has been applied for MHRD. Silicone oil and C3Fs have been used as intraocular tamponade materials,while there are still controversity on their efficacy. Objective This trial was to evaluate the efficacy of vitreous surgery combined with silicone oil or C3F8 tamponade for patients with MHRD in highly myopic eyes. Methods A retrospective case-controlled study was designed. Fifty-one patients who underwent vitrectomy with intraocular tamponade were retrospectively analyzed. The best corrected visual acuity（BCVA） before and after surgery were examined and campared between two groups. The rate of recurrent RD and macular hole closed were analyzed. Results There was no significant difference in BCVA between silicone oil group and C3F8 tamponade group before and after surgery （ U = 266. 000, P = O. 286 ; U = 205. 000, P = 0. 029 ）. The BCVA after surgery was elevated in both groups（Z=-2. 729,P=0. 006;Z=-3. 273,P=0. 001）. The rates of recurrent RD and macular hole closed were no difference between two groups （ P = 0. 894,1. 000）. There were no other complications but cataract. Conclusions C3F8 tamponade of MHRD in high myopic eyes show the same efficacy as silicone oil tamponade.