Cho Hee Yoon, Kim Yun Taek, Kang Se Woong
Department of Ophthalmology, Sungkyunkwan University, School of Medicine, Samsung Medical Center, Seoul, Korea.
Korean J Ophthalmol. 2006 Jun;20(2):93-8. doi: 10.3341/kjo.2006.20.2.93.
To evaluate the effectiveness of laser photocoagulation as adjuvant therapy in the treatment of large macular holes.
A randomized clinical trial. Thirty-one eyes from 29 subjects with idiopathic macular holes of diameters larger than 400 microm were randomized into a laser group and a control group. All eyes underwent vitrectomy with peeling of the internal limiting membrane. Contrary to the control group eyes, the laser group eyes underwent laser photocoagulation at the center of the macular hole before vitrectomy. Visual acuity and anatomic outcomes assessed by optical coherence tomography (OCT) were analyzed 3 months after surgery.
On postoperative OCT, closure of the macular hole was noted in 17 of the 18 (94.4%) laser group eyes and 10 of the 13 (76.9%) control group eyes. Hole closure without bare retinal pigment epithelium was observed in 16 eyes in the laser group and 6 eyes in the control group (P < 0.05). The amount of improvement in logMAR visual acuity 3 months after surgery was 0.40 +/- 0.29 in the laser group, and 0.19 +/- 0.23 in the control group (P < 0.05).
Laser photocoagulation constitutes a potent adjuvant therapy that may improve anatomical and visual outcomes of surgery for macular holes larger than 400 microm.
评估激光光凝作为辅助治疗手段在治疗大的黄斑裂孔中的有效性。
一项随机临床试验。将29例直径大于400微米的特发性黄斑裂孔子的31只眼随机分为激光组和对照组。所有眼睛均接受玻璃体切除术并剥除内界膜。与对照组眼睛不同，激光组眼睛在玻璃体切除术前行黄斑裂孔中心的激光光凝。术后3个月分析通过光学相干断层扫描（OCT）评估的视力和解剖学结果。
术后OCT显示，激光组18只眼中有17只（94.4%）黄斑裂孔闭合，对照组13只眼中有10只（76.9%）黄斑裂孔闭合。激光组16只眼和对照组6只眼观察到无裸露视网膜色素上皮的裂孔闭合（P<0.05）。术后3个月激光组logMAR视力改善量为0.40±0.29，对照组为0.19±0.23（P<0.05）。
激光光凝是一种有效的辅助治疗方法，可改善直径大于400微米的黄斑裂孔手术的解剖学和视力结果。
