玻璃体切割联合内界膜剥离术治疗高度近视黄斑裂孔性视网膜脱离

目的 探讨玻璃体切割联合内界膜剥离术治疗高度近视黄斑裂孔性视网膜脱离(MHRD)的效果.方法 选取2017年2月至2019年2月中国人民解放军空军军医大学第一附属医院眼科收治的180例(180眼)高度近视MHRD患者作为研究对象,采用随机数字表法分为观察组(92例)及对照组(88例),两组患者均常规行三切口玻璃体切割术...

Vitrectomy combined with internal limiting membrane peeling in the treatment of macular hole retinal detachment in high myopic eyes

Objective　To explore the effects of vitrectomy combined with internal limiting membrane peelingin the treatment of macular hole retinal detachment (MHRD) in high myopic eyes.Methods　Totally 180 patients (180 eyes) with high myopia and MHRD who were admitted to the Department of Ophthalmology at the First Affiliated Hospital of PLA Air Force Military Medical University were selected as the research subjects between February 2017 and February 2019. The patients enrolled were divided into observation group (92 patients) and control group (88 patients) by random number table method. All patients underwent conventional three-incision vitrectomy, and patients in the observation group were additionally treated with internal limiting membrane peeling. The situation of macular hole closure and retinal reattachment was observed, and visual acuity as well as visual function was tested. The incidence of postoperative complications was counted.Results　The macular hole closure rate was 71.43% in the observation group and 65.91% in the control group, respectively, with statistically significance (P<0.05), and retinal reattachment rates were 95.65% and 90.91%, respectively, but no statistically significance (P>0.05). The postoperative visual acuity of the observation group and the control group was (39.26±3.45) letters and (38.17±2.96) letters, respectively, which was significantly higher compared to pre-operation (both P<0.05), but there was no significant difference between the observation group and the control group (P>0.05). The mean light sensitivity in macular area was significantly increased in the two groups, and the observation group had lower mean light sensitivity than the control group (P<0.05). There was no statistically significant difference in fixation between the two groups (P>0.05). After operation, the response density of the first ring of P1 wave in the first order kernel in multifocal electroretinogram (mfERG) was (110.12±20.63) nV·deg^-2 for the observation group and (134.15±25.96) nV·deg^-2 for the control group, and the response density of the second ring of P1 wave was (70.14±11.96) nV·deg^-2 for the observation group and (66.96±12.71) nV·deg^-2 for the control group, all of which were significantly higher compared to pre-operation ［the response density of the first ring of P1 wave:(55.74±11.41) nV·deg^-2 for the observation group and (56.01±10.28) nV·deg^-2 for the control group, the response density of the second ring of P1 wave:(47.14±10.27) nV·deg^-2 for the observation group and (49.22±9.63) nV·deg^-2 for the control group］ (all P<0.05). It was found that the response density of the first ring of P1 wave was lower in the observation group than in the control group (P<0.05). There was no statistically significant difference in the incidence of complications between the two groups (P>0.05).Conclusion　Compared with simple vitrectomy, vitrectomy combined with internal limiting membrane peeling can promote macular hole healing in patients with high myopia and MHRD, but it has certain influence on micro field and retinal function.