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黄斑假性裂孔性视网膜前膜手术的视觉预后

Visual outcome of surgery for epiretinal membranes with macular pseudoholes.

作者信息

Massin P, Paques M, Masri H, Haouchine B, Erginay A, Blain P, Gaudric A

机构信息

Department of Ophthalmology, Hôpital Lariboisière, Université Paris, France.

出版信息

Ophthalmology. 1999 Mar;106(3):580-5. doi: 10.1016/S0161-6420(99)90119-7.

Abstract

OBJECTIVE

To evaluate the effect of macular pseudohole on visual results after epiretinal membrane (ERM) surgery.

DESIGN

Retrospective case-control study.

PARTICIPANTS

The postoperative results for 50 eyes with ERMs combined with pseudohole were compared with the results for a paired series of idiopathic ERMs without pseudohole operated on during the same period.

INTERVENTION

All patients underwent standard three-port pars plana vitrectomy, including core vitrectomy, and removal of the membrane.

MAIN OUTCOME MEASURES

Anatomic and functional evaluations were performed before and after surgery. Main outcome measures were postoperative visual acuity and the persistence or disappearance of the pseudohole.

RESULTS

For the patients with pseudohole, median preoperative visual acuity was 20/63 (range, 20/32-20/860) and median postoperative visual acuity was 20/40 (range, 20/20-20/860). Vision improved by 2 or more lines in 31 (62%) of 50 eyes. Forty eyes (80%) reached visual acuity of 20/50 or more. Pseudohole persisted in 22 eyes (44%) 3 months after surgery and in 15 eyes (30%) at 6 months. There was no difference in visual acuity, whether or not the pseudohole persisted. For the patients without pseudohole, median preoperative visual acuity was 20/63 (range, 20/32-20/860). Median postoperative visual acuity was 20/40 (range, 20/20-20/860). Vision improved by 2 or more lines in 37 eyes (74%). In 36 eyes (72%), it was 20/50 or more. Neither preoperative nor postoperative visual acuity differed significantly in the groups with and without pseudohole.

CONCLUSION

After surgery for idiopathic ERMs combined with pseudohole, visual outcome is good, and pseudohole has no adverse prognostic value. Pseudohole disappears inconstantly after surgery, but its persistence does not preclude good postoperative visual recovery.

摘要

目的

评估黄斑假性裂孔对视网膜前膜(ERM)手术后视觉效果的影响。

设计

回顾性病例对照研究。

研究对象

将50只合并假性裂孔的ERM患者术后结果与同期配对的一系列无假性裂孔的特发性ERM患者术后结果进行比较。

干预措施

所有患者均接受标准三通道平坦部玻璃体切除术,包括核心玻璃体切除术及膜剥除术。

主要观察指标

手术前后进行解剖学和功能评估。主要观察指标为术后视力及假性裂孔的持续或消失情况。

结果

对于有假性裂孔的患者,术前视力中位数为20/63(范围20/32 - 20/860),术后视力中位数为20/40(范围20/20 - 20/860)。50只眼中有31只(62%)视力提高2行或更多。40只眼(80%)达到20/50或更好的视力。术后3个月,22只眼(44%)假性裂孔持续存在,6个月时15只眼(30%)仍存在。无论假性裂孔是否持续存在,视力均无差异。对于无假性裂孔的患者,术前视力中位数为20/63(范围20/32 - 20/860),术后视力中位数为20/40(范围20/20 - 20/860)。37只眼(74%)视力提高2行或更多。36只眼(72%)达到20/50或更好的视力。有和无假性裂孔的两组患者术前和术后视力均无显著差异。

结论

特发性ERM合并假性裂孔手术后,视觉效果良好,假性裂孔无不良预后价值。假性裂孔术后消失情况不一,但其持续存在并不妨碍术后良好的视力恢复。

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