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近视性黄斑裂孔性视网膜脱离行临时性硅油填充联合激光光凝治疗的长期随访

Long-term follow-up of retinal detachment due to macular hole in myopic eyes treated by temporary silicone oil tamponade and laser photocoagulation.

作者信息

Wolfensberger T J, Gonvers M

机构信息

Hôpital Ophtalmique Jules Gonin, University of Lausanne, Switzerland.

出版信息

Ophthalmology. 1999 Sep;106(9):1786-91. doi: 10.1016/S0161-6420(99)90344-5.

Abstract

PURPOSE

To determine the long-term anatomic and functional results of temporary silicone oil tamponade coupled with laser photocoagulation of the macular hole rim for retinal detachment due to macular hole in eyes with myopia higher than -10.0 diopters (D).

DESIGN

Retrospective, noncomparative case series.

PARTICIPANTS

Eleven patients (9 female, 2 male; average age, 57+/-3 years) with spontaneous retinal detachment due to macular hole. All patients had a myopia higher than -10.0 D and had no proliferative vitreoretinopathy and no history of trauma. The average myopia amounted to -17.7+/-1.1 D, and in eight cases, a large posterior staphyloma was present. Follow-up was 69+/-17 months.

INTERVENTION

Patients underwent pars plana vitrectomy, temporary silicone oil tamponade, and laser photocoagulation of the macular hole rim. Silicone oil removal was performed after 2.8+/-0.8 months.

MAIN OUTCOME MEASURES

Anatomic attachment of the retina was determined and visual acuity was measured.

RESULTS

Final successful retinal attachment at the end of follow-up was achieved in ten eyes (91 %). Average logarithm of the minimum angle of resolution (logMAR) visual acuity increased from 1.39+/-0.12 before surgery to 1.18+/-0.13 after surgery (P < 0.05, Student's t test for paired data). This corresponds to a mean increase of measured Snellen equivalents from 0.06+/-0.03 to 1.11+/-0.04. Intraocular pressures remained stable with 13.9+/-1.8 millimeters of mercury (mmHg) before surgery and 16.6+/-1.6 mmHg at the end of follow-up (P > 0.05).

CONCLUSIONS

Primary vitrectomy with temporary silicone oil tamponade and laser photocoagulation of the macular hole rim for retinal detachment due to macular hole in highly myopic eyes appears to provide a good long-term anatomic success and acceptable functional results.

摘要

目的

确定对于近视度数高于-10.0屈光度(D)的眼中因黄斑裂孔导致视网膜脱离的情况,采用临时性硅油填充联合黄斑裂孔边缘激光光凝术的长期解剖学和功能学结果。

设计

回顾性、非对照病例系列。

研究对象

11例因黄斑裂孔导致自发性视网膜脱离的患者(9例女性,2例男性;平均年龄57±3岁)。所有患者近视度数高于-10.0 D,无增殖性玻璃体视网膜病变且无外伤史。平均近视度数为-17.7±1.1 D,8例存在较大的后巩膜葡萄肿。随访时间为69±17个月。

干预措施

患者接受了玻璃体切除术、临时性硅油填充以及黄斑裂孔边缘激光光凝术。在2.8±0.8个月后取出硅油。

主要观察指标

确定视网膜的解剖复位情况并测量视力。

结果

随访结束时,10只眼(91%)最终成功实现视网膜复位。平均最小分辨角对数(logMAR)视力从术前的1.39±0.12提高至术后的1.18±0.13(P<0.05,配对数据的Student t检验)。这相当于测量的Snellen等效值平均从0.06±0.03提高至1.11±0.04。眼压保持稳定,术前为13.9±1.8毫米汞柱(mmHg),随访结束时为16.6±1.

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