Kwok A K H, Lai T Y Y, Yip W W K
Department of Ophthalmology, Hong Kong Sanatorium and Hospital, Hong Kong, People's Republic of China.
Br J Ophthalmol. 2005 Sep;89(9):1180-3. doi: 10.1136/bjo.2005.069427.
To evaluate the clinical and anatomical outcomes of pars plana vitrectomy and gas tamponade without internal limiting membrane (ILM) peeling in symptomatic patients caused by myopic foveoschisis.
Nine eyes in eight highly myopic patients who had myopic foveoschisis with foveal detachment underwent vitrectomy without ILM peeling followed by gas tamponade. Main outcome measures include change in best corrected visual acuity (BCVA) and changes in height of the foveal detachment and resolution of the myopic foveoschisis measured by optical coherence tomography (OCT).
After surgery, BCVA improved in eight eyes with the median BCVA improved from 20/80 to 20/50 (p=0.012). The mean line of visual improvement was 3.6 lines. OCT showed complete resolution of myopic foveoschisis with complete foveal reattachment in seven (77.8%) eyes with partial resolution in two (22.2%) eyes. The mean height of foveal detachment decreased from 505 mum preoperatively to 21 mum postoperatively (p<0.001).
Vitrectomy without ILM peeling followed by gas tamponade appeared to result in favourable visual and anatomical outcomes for treating myopic foveoschisis in highly myopic eyes. The results are comparable with studies in which ILM removal was performed. Further controlled study will be useful to determine the role of ILM peeling in these patients.
评估在高度近视性黄斑劈裂导致的有症状患者中,不进行内界膜(ILM)剥除的玻璃体切割联合气体填充术的临床和解剖学结果。
8例高度近视患者的9只眼睛患有近视性黄斑劈裂伴黄斑脱离,接受了不进行ILM剥除的玻璃体切割术,随后进行气体填充。主要观察指标包括最佳矫正视力(BCVA)的变化、黄斑脱离高度的变化以及通过光学相干断层扫描(OCT)测量的近视性黄斑劈裂的消退情况。
术后,8只眼睛的BCVA有所改善,BCVA中位数从20/80提高到20/50(p=0.012)。视力改善的平均线数为3.6线。OCT显示,7只(77.8%)眼睛的近视性黄斑劈裂完全消退,黄斑完全复位,2只(22.2%)眼睛部分消退。黄斑脱离的平均高度从术前的505μm降至术后的21μm(p<0.001)。
不进行ILM剥除的玻璃体切割术联合气体填充术,对于治疗高度近视眼中的近视性黄斑劈裂似乎能带来良好的视力和解剖学结果。这些结果与进行ILM切除的研究结果相当。进一步的对照研究将有助于确定ILM剥除在这些患者中的作用。