Thompson John T
Greater Baltimore Medical Center, Baltimore, Maryland, USA.
Trans Am Ophthalmol Soc. 2004;102:97-103; discussion 103-5.
To evaluate the visual results of vitrectomy for epiretinal membrane in eyes with a preoperative visual acuity of 20/50 or better.
The visual results and complications were analyzed following vitrectomy for idiopathic epiretinal membranes and epiretinal membranes secondary to retinal tears. This study was a retrospective, consecutive case series of 40 eyes of 40 patients treated by a single surgeon.
The mean preoperative visual acuity was 20/50 +2 (range, 20/30 +1 to 20/50 -3). The mean visual acuity improved to 20/40 +2 (P = .02) by the final examination at a mean of 2.4 years following surgery. The status of the lens at the final examination was correlated with the visual results of surgery. Twenty-one eyes were phakic preoperatively, and 14 of these eyes had cataracts removed by the final examination. The mean preoperative visual acuity in seven eyes that were still phakic at the final examination was 20/50, and this decreased to 20/50 -2 (P = .82). The mean preoperative visual acuity was 20/50 +2 in 33 eyes that were pseudophakic by the final examination, and this improved to 20/32 -2 (P = .005). The visual acuity improved by 2 or more Snellen lines in only one in seven eyes (14%) that were still phakic on the final examination and in 14 of 33 eyes (42.4%) that were pseudophakic by the final examination. There were no serious surgical complications.
Vitrectomy for epiretinal membranes is beneficial in eyes with relatively good preoperative visual acuities, but cataract surgery is necessary in phakic eyes to achieve long-term visual acuity improvement.
评估术前视力为20/50或更好的眼行玻璃体切除术治疗视网膜前膜的视觉效果。
分析特发性视网膜前膜及视网膜裂孔继发的视网膜前膜行玻璃体切除术后的视觉效果及并发症。本研究为回顾性、连续病例系列,共40例患者的40只眼,均由同一位外科医生治疗。
术前平均视力为20/50 +2(范围为20/30 +1至20/50 -3)。术后平均2.4年进行最终检查时,平均视力提高到20/40 +2(P = .02)。最终检查时晶状体状态与手术视觉效果相关。术前21只眼为有晶状体眼,其中14只眼在最终检查时行白内障摘除术。最终检查时仍为有晶状体眼的7只眼中,术前平均视力为20/50,降至20/50 -2(P = .82)。最终检查时为人工晶状体眼的33只眼中,术前平均视力为20/50 +2,提高到20/32 -2(P = .005)。最终检查时仍为有晶状体眼的7只眼中,仅1只眼(14%)视力提高2行或更多Snellen行;最终检查时为人工晶状体眼的33只眼中,14只眼(42.4%)视力提高2行或更多Snellen行。无严重手术并发症。
对于术前视力相对较好的眼,玻璃体切除术治疗视网膜前膜有益,但有晶状体眼需行白内障手术以实现长期视力提高。