特发性黄斑裂孔患者玻璃体术后黄斑结构和中央凹视网膜厚度变化

目的：分析特发性黄斑裂孔患者接受23G玻璃体手术治疗后黄斑结构的修复情况，以及视力和黄斑中央凹视网膜厚度的变化。

方法：将2016-06/2017-12在我院进行择期手术的单眼特发性黄斑裂孔患者85例85眼纳入研究，其中男37例，女48例，平均年龄64.7±10.1岁。所有患者均接受23G玻璃体切割术，应用OCT观察术后黄斑裂孔闭合情况； 应用OCT观察术前和术后1、3、6mo黄斑中央凹视网膜厚度的变化； 观察术前和术后1、3、6mo患者最佳矫正视力的变化。

结果：术后所有患者获得良好的黄斑裂孔闭合。术后3、6mo时所有患者平均最佳矫正视力显著高于术前和术后1mo(P<0.05)； 术后6mo平均最佳矫正视力显著高于术后3mo，差异有统计学意义(t=7.983，P=0.037)。术后1mo黄斑中央凹视网膜厚度显著高于术前和术后3、6mo(P<0.05)； 术后3、6mo的黄斑中央凹视网膜厚度显著低于术前(P<0.05)。

结论：应用23G玻璃体切除术治疗特发性黄斑裂孔具有较高的裂孔成功闭合率，患者的视力明显提高。

Changes of macular structure and retinal thickness in macular area after vitrectomy for idiopathic macular hole

AIM:The repair of macular structure after 23G vitrectomy was performed in patients with idiopathic macular hole, and the changes of retinal thickness in vision and macular area were analyzed.

METHODS: A total of 85 patients(85 eyes)with monocular idiopathic macular hole who underwent elective surgery in our hospital from June 2016 to December 2017 were included in the study, of which 37 were male and 48 were female, with an average age of(64.7±10.1)years. All subjects underwent 23G vitrectomy were observed the closure of macular hole after operation, and the changes of retinal thickness in macular forea were observed preoperatively and postoperatively by optical coherence tomography(OCT). To observe the changes of the best corrected visual acuity(BCVA)in preoperative, 1mo, 3mo and 6mo after operation.

RESULTS: All subjects underwent postoperative examinations had good macular hole closure. The average BCVA of 3mo and 6mo after operation were significantly higher than that of preoperative and 1mo after operation(P<0.05); the average BCVA in 6mo after operation was significantly higher than the average BCVA of 6mo after operation, with statistically significant differences(t=7.983, P=0.037). The macular central fovea thickness in 1mo after operation was significantly higher than preoperative and 3mo, 6mo after operation(P<0.05); The retinal thickness of the macular fovea thickness in 3mo and 6mo after operation were significantly lower than that of preoperative.

CONCLUSION:The treatment of idiopathic macular hole with 23G vitrectomy had a high degree of successful closure rate of fracture hole and the visual acuity of patients was obviously improved.