Shinjo Ophthalmologic Institute, Miyazaki, Japan.
Retina. 2010 Jun;30(6):874-80. doi: 10.1097/IAE.0b013e3181c703fc.
The purpose of this study was to determine the factors that are correlated with the visual outcomes in patients who underwent pars plana vitrectomy with internal limiting membrane peeling for myopic foveoschisis (MF).
In this retrospective, interventional consecutive case series, 39 eyes of 39 consecutive patients who had undergone pars plana vitrectomy with internal limiting membrane peeling for MF were studied. Preoperative optical coherence tomography showed that none of the eyes had a macular hole or vitreoretinal traction. Eyes were divided into those with MF and a foveal detachment (FD; FD group, n = 27) and those with MF without an FD (no-FD group, n = 12). The main outcome measures were best-corrected visual acuity (BCVA) and the optical coherence tomography findings.
Optical coherence tomography showed a complete resolution of the MF with a reattachment of the fovea in all eyes, and the retina remained attached during the mean follow-up of 41 months. The final mean BCVA improved significantly in the FD group (P = 0.0003) but not in the no-FD group (P = 0.56). The final BCVA of the FD group and no-FD group improved in 70% and 42%, remained unchanged in 26% and 33%, and worsened in 4% and 25% of the eyes, respectively. A better final BCVA was significantly correlated with a better preoperative BCVA (P < 0.0001), a shorter axial length (P = 0.045), and the presence of an FD (P = 0.028).
Pars plana vitrectomy with internal limiting membrane peeling results in long-term favorable anatomical and visual outcomes. Eyes with an FD may be good candidates for surgery.
本研究旨在确定行内界膜剥除的睫状体平坦部玻璃体切除术治疗近视性黄斑劈裂（MF）患者的相关视觉预后因素。
本回顾性、干预性连续病例系列研究纳入了 39 例（39 只眼）接受内界膜剥除的睫状体平坦部玻璃体切除术治疗 MF 的连续患者。术前光学相干断层扫描显示，无眼存在黄斑裂孔或眼内牵引。将眼分为伴有黄斑裂孔伴中心凹脱离（FD 组，n = 27）和不伴有黄斑裂孔伴中心凹脱离（无 FD 组，n = 12）。主要观察指标为最佳矫正视力（BCVA）和光学相干断层扫描结果。
光学相干断层扫描显示，所有眼的 MF 完全消退，黄斑中心凹复位，视网膜在平均 41 个月的随访期间保持在位。FD 组的最终平均 BCVA 显著改善（P = 0.0003），而无 FD 组则无显著改善（P = 0.56）。FD 组和无 FD 组的最终 BCVA 改善分别为 70%和 42%，不变分别为 26%和 33%，恶化分别为 4%和 25%。更好的最终 BCVA 与更好的术前 BCVA（P < 0.0001）、较短的眼轴（P = 0.045）和 FD 的存在（P = 0.028）显著相关。
行内界膜剥除的睫状体平坦部玻璃体切除术可获得长期良好的解剖和视觉效果。伴有 FD 的眼可能是手术的良好候选者。
