Tadayoni R, Gaudric A, Haouchine B, Massin P
Service d'Ophtalmologie, Hôpital Lariboisière, 2, Rue Ambroise Paré, Paris, France.
Br J Ophthalmol. 2006 Oct;90(10):1239-41. doi: 10.1136/bjo.2006.091777. Epub 2006 Jun 29.
To investigate the relationship between the size of macular holes and the possible benefit of internal limiting membrane (ILM) peeling.
84 consecutive cases of idiopathic macular hole followed up for at least 3 months were included in this retrospective study. Surgery comprised pars plana vitrectomy, peeling of any epiretinal membrane, 17% C2F6 (hexafluoroethane) gas filling and 10 days of positioning. 36 eyes had ILM peeling. The main outcome measure was the macular hole closure rate checked by optical coherence tomography.
The overall postoperative closure rate was 90.5%. For macular holes > or =400 microm in diameter, the rate was 100% with ILM peeling versus 73.3% without (p = 0.015). For smaller macular holes, the rates were 100% in both groups. Postoperative gain in visual acuity was not significantly different in eyes with ILM peeling and those without.
ILM peeling does not seem to be useful for macular hole <400 mum in diameter. Its likely benefit has to be investigated for larger macular hole sizes, for which the failure rate is higher.
探讨黄斑裂孔大小与内界膜（ILM）剥除可能带来的益处之间的关系。
本回顾性研究纳入了84例连续的特发性黄斑裂孔患者，这些患者均接受了至少3个月的随访。手术包括玻璃体切除术、剥除任何视网膜前膜、注入17%的C2F6（六氟乙烷）气体并进行10天的体位摆放。36只眼进行了ILM剥除。主要观察指标是通过光学相干断层扫描检查黄斑裂孔闭合率。
术后总体闭合率为90.5%。对于直径≥400微米的黄斑裂孔，ILM剥除组的闭合率为100%，未进行ILM剥除组的闭合率为73.3%（p = 0.015）。对于较小的黄斑裂孔，两组的闭合率均为100%。ILM剥除组和未剥除组术后视力提高情况无显著差异。
ILM剥除对于直径<400微米的黄斑裂孔似乎并无作用。对于较大的黄斑裂孔（其失败率较高），其可能带来的益处有待进一步研究。
