亮蓝辅助视网膜内界膜剥离治疗病理性近视黄斑裂孔视网膜脱离的疗效评估

目的 评估亮蓝(BBG)辅助视网膜内界膜(ILM)剥离治疗病理性近视黄斑裂孔视网膜脱离的安全性和有效性.方法 前瞻性非对照研究.27例病理性近视黄斑裂孔视网膜脱离患者27只眼纳入研究.常规行最佳矫正视力(BCVA)、眼压、裂隙灯显微镜+90 D前置镜眼底检查,A和(或)B型超声、光相干断层扫描(OCT)及视野检查.所有患者行玻璃体切割手术(PPV),手术中采用BBG辅助ILM剥离,手术后采用C3F8气体填充.观察患者有无视网膜或角膜水肿、前房炎症反应、眼压增高等BBG毒性反应.手术后1、7 d,1、3、6个月进行随访,采用手术前相同的仪器设备行相关检查,对比分析手术前后BCVA、眼压、眼底表现、视野变化、黄斑裂孔闭合、视网膜复位等情况.结果 BBG辅助下,所有患者均完整地剥离ILM.无手术后角膜水肿、前房反应、眼压升高、视野缺损等不良反应发生.手术后1个月,27只眼中26只眼黄斑裂孔闭合、视网膜完全复位,占96.3%;1只眼黄斑裂孔未闭合、视网膜再脱离,占3.7%.手术后6个月,27只眼中25只眼视力提高,占92.6%;2只眼视力不变,占7.4%.手术前后BCVA比较,差异有统计学意义(t=6.08,P＜0.05).结论 BBG可充分染色ILM,且无不良反应发生;其辅助ILM剥离治疗病理性近视黄斑裂孔视网膜脱离安全有效.

Brilliant blue G assisted internal limiting membrane peeling on pathological myopic macular holes with retinal detachment

Objective To evaluate the safety and efficacy of brilliant blue G (BBG) assisted internal limiting membrane (ILM) peeling on pathological myopic macular holes with retinal detachment. Methods This is a prospective and non-controlled study. Twenty-seven high myopia patients (27 eyes) with macular holes and retinal detachment were enrolled. Routine examination was performed, including the best corrected visual acuity (BCVA), intraocular pressure, slit lamp microscope with +90 D pre-set lens, A- or B-ultrasound, optical coherence tomography (OCT) and visual field. All patients received vitrectomy with BBG-assisted ILM peeling and C3F8 gas tamponade. The 5 follow-up visits were at the first day, the seventh day, the first month, the third month and the sixth month after surgery. The BCVA, intraocular pressure,visual field, macular hole and retinal reattachment were comparatively analyzed. Results The ILM of all patients were peeled completely by BBG staining. There were no major complications such as corneal edema,anterior chamber reaction, elevated intraocular pressure, visual field defects. At the first month after surgery, macular hole closed and retina reattached in 26 eyes (96.3%), the macular hole did not close and retina re-detached in one eye (25. 9%). At the sixth month after surgery, BCVA of 25 eyes (92. 6%)increased, two eyes (7.4 % ) didn't change, the difference was statistically significant (t = 6.08, P＜0.05).Conclusions BBG can fully stain ILM without any side effects. Vitrectomy with BBG-assisted ILM peeling is a safe and effective treatment for pathological myopic macular holes with retinal detachment.