Hikichi Taiichi, Furukawa Yuuko, Ohtsuka Hideo, Higuchi Makoto, Matsushita Takuro, Ariga Hiroko, Kosaka Shyoko, Matsushita Reiko
Ohtsuka Eye Hospital, Kita-16 Nishi-4. Kita-ku, Sapporo, Japan.
Am J Ophthalmol. 2008 Feb;145(2):267-272. doi: 10.1016/j.ajo.2007.09.035. Epub 2007 Dec 11.
To investigate whether triamcinolone acetonide in the macular hole after surgery interferes with anatomic macular hole repair or visual acuity improvement.
Prospective, interventional case series with historical comparison.
Pars plana vitrectomy and triamcinolone acetonide-assisted internal limiting membrane peeling were performed in 26 eyes (24 patients) with stage 3 or 4 idiopathic macular hole. The visual acuities one-year after surgery were compared between eyes with and without residual triamcinolone acetonide after surgery.
The macular holes were closed successfully in all 26 eyes. Nine eyes (35%) had residual triamcinolone acetonide in the macular hole at the end of the surgery and in the fovea on day 3 after surgery. The mean preoperative logarithm of the minimum angle of resolution (logMAR) visual acuity +/- standard deviation was 0.73 +/- 0.36 and improved significantly to 0.20 +/- 0.29 one-year after surgery (P = .010). In the nine eyes with residual triamcinolone acetonide, the preoperative mean logMAR triamcinolone acetonide was 0.81 +/- 0.33, which improved to 0.20 +/- 0.19 one-year after surgery (P = .013). In the remaining 17 eyes, the mean visual acuity also improved from 0.71 +/- 0.38 before surgery to 0.21 +/- 0.28 after surgery (P = .001). No significant difference was found between the groups in preoperative and postoperative logMAR visual acuities.
Residual triamcinolone acetonide in the macular hole does not interfere with anatomic or visual improvement.
研究曲安奈德在黄斑裂孔手术后是否会干扰黄斑裂孔的解剖修复或视力提高。
有历史对照的前瞻性干预性病例系列研究。
对26只眼(24例患者)的3或4期特发性黄斑裂孔进行玻璃体平坦部玻璃体切除术及曲安奈德辅助的内界膜剥除术。比较术后有和无残留曲安奈德的患眼术后一年的视力。
所有26只眼的黄斑裂孔均成功闭合。9只眼(35%)在手术结束时黄斑裂孔及术后第3天的黄斑中心凹有残留曲安奈德。术前最小分辨角对数(logMAR)视力的平均值±标准差为0.73±0.36,术后一年显著提高至0.20±0.29(P = 0.010)。在9只残留曲安奈德的眼中,术前平均logMAR视力为0.81±0.33,术后一年提高至0.20±0.19(P = 0.013)。在其余17只眼中,平均视力也从术前的0.71±0.38提高到术后的0.21±0.28(P = 0.001)。两组术前和术后的logMAR视力之间未发现显著差异。
黄斑裂孔中残留的曲安奈德不会干扰解剖结构的改善或视力提高。