玻璃体切割联合内界膜覆盖术治疗高度近视黄斑裂孔视网膜脱离

目的:比较玻璃体切割联合内界膜剥除术或内界膜覆盖术治疗高度近视黄斑裂孔视网膜脱离(MHRD)的疗效。方法:回顾性临床研究。选取2020-01/2021-06于我院行玻璃体切割联合内界膜剥除术或内界膜覆盖术治疗的高度近视MHRD患者38例38眼，根据手术方式分为对照组(行玻璃体切割联合内界膜剥除术)和观察组(行玻璃体切割联合内界膜覆盖术)。随访至术后3mo,比较两组患者手术时间、最佳矫正视力(BCVA)、黄斑裂孔闭合和视网膜复位情况。结果:两组患者手术时间无差异(30.71±4.55min vs 35.20±5.44min,P=0.384)。末次随访时，两组患者BCVA均较术前明显改善(均P<0.01),但两组患者BCVA(LogMAR)无差异(1.39±0.24 vs 1.46±0.27,P=0.700);观察组患者黄斑裂孔闭合率高于对照组(100%vs 71%,P=0.024),但两组患者视网膜再脱离率比较无差异(0 vs 10%,P=0.492)。结论:两种手术方式均可改善患者视力，但玻璃体切割联合内界膜覆盖术后黄斑裂孔闭合率更高。

Pars plana vitrectomy combined with inverted internal limiting membrane flap technique for the treatment of macular hole retinal detachment in high myopia

AIM: To compare the efficacy of pars plana vitrectomy(PPV)combined with internal limiting membrane(ILM)peeling or inverted ILM flap for the treatment of macular hole retinal detachment(MHRD)in high myopia.

METHODS: A retrospective clinical study. A total of 38 cases(38 eyes)with MHRD in high myopia were treated with PPV combined with ILM peeling or PPV combined with inverted ILM flap in our hospital from January 2020 to June 2021. They were divided into control group(PPV combined with ILM peeling)and observation group(PPV combined with inverted ILM flap)according to the surgical method. Follow-up to 3mo after surgery, the surgery time, best corrected visual acuity(BCVA), the rate of macular hole closure and retinal reattachment were compared between two groups.

RESULTS: The surgery time of two groups were compared and there were no statistically significant difference(30.71±4.55min vs. 35.20±5.44min, P=0.384). The BCVA in the two groups were significantly improved at the last follow-up(all P<0.01). But there was no difference in the postoperative BCVA(LogMAR)of the two groups(1.39±0.24 vs. 1.46±0.27, P=0.700). The rate of macular hole closure in the observation group was higher than that of control group(100% vs. 71%, P=0.024). There was no difference in the rate of recurrent retinal detachment of the patients in two groups(0 vs. 10%, P=0.492).

CONCLUSION: Both surgeries can improve the BCVA, while PPV combined with inverted ILM flap has higher rate of macular hole closure.