有无黄斑中心凹下沉积物的特发性黄斑前膜治疗效果比较

目的　对比观察特发性黄斑前膜有无黄斑中心凹下沉积物手术前后情况。方法　回顾性非随机临床研究。41例41眼特发性黄斑前膜患者分为2组，组1为有黄斑中心凹下沉积物者8例8眼，组2为没有黄斑中心凹下沉积物者33例33眼。所有患者均接受标准经睫状体平坦部三通道25G玻璃体切割联合内界膜剥除术。对比观察两组术前和术后1个月、3个月、6个月的最佳矫正视力（best corrected visual acuity，BCVA）和黄斑中心凹视网膜厚度（central macular thickness，CMT）情况，同时观察并发症发生情况。结果　术后6个月，组1、组2 BCVA分别为（0.65±0.24）logMAR、（0.54±0.26）logMAR，均较术前明显提高，差异有统计学意义（均为P=0.00）；两组间术前、术后6个月BCVA差异均无统计学意义（均为P>0.05）。术后6个月，组1、组2 CMT分别为（288.38±64.64）μm、（299.85±37.19）μm，均较术前显著降低，差异均有统计学意义（均为P=0.00）；两组间术前、术后6个月CMT相比差异均无统计学意义（均为P>0.05）。随访期间，所有患眼均未见黄斑前膜复发。结论　25G玻璃体切割联合内界膜剥除治疗特发性黄斑前膜，可稳定提高患者的BCVA，促进黄斑结构的恢复，有无黄斑中心凹下沉积物对术后BCVA、CMT无明显影响。

Subfoveal deposits in idiopathic macular epiretinal membrane

Objective　To compare the preoperative and postoperative course of subfoveal deposits in idiopathic macular epiretinal membrane(IEM).Methods　This retrospective，non-randomised，comparative clinical study.We divided 41 patients (41 eyes) with IEM into 8 eyes of 8 patients with subfoveal deposits as group 1 and 33 eyes of 33 patients without subfoveal deposits as group 2.All patients were treated by 25G micro-incision vitrectomy and internal limiting membrane (ILM) removal.The changes of the best corrected visual acuity(BCVA)，central macular thickness(CMT) were compared at preoperative and postoperative 1，3，6 months.Results　At the 6 months after surgery，the mean BCVA was (0.65±0.24)logMAR in group 1，and (0.54±0.26)logMAR in group 2，significant postoperative improvements were observed in both groups(both P=0.00)；the difference was not significant in both groups at preoperative and postoperative 6 months(both P>0.05).The mean CMT was (288.38±64.64)μm in group 1，and (299.85±37.19)μm in group 2，significant postoperative improvements were observed in both groups(both P=0.00)；the difference was not significant in both groups at preoperative and postoperative 6 months(both P>0.05).No patients of IEM was recurrenced during in 6 months.Conclusion　25G micro-incision vitrectomy and ILM removal is an efficient and safe treatment for IEM，they can improve BCVA and foveal morphology.Subfoveal deposits does not significantly influence on postoperative BCVA and CMT.