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玻璃体切割术治疗黄斑静脉阻塞时内界膜剥除的可能影响。

Possible effects of internal limiting membrane peeling in vitrectomy for macular vein occlusion.

机构信息

Shinjo Ophthalmologic Institute, Miyazaki, Japan.

出版信息

Jpn J Ophthalmol. 2010 Jan;54(1):61-5. doi: 10.1007/s10384-009-0750-z. Epub 2010 Feb 12.

Abstract

PURPOSE

To evaluate the effect of pars plana vitrectomy (PPV) either with or without internal limiting membrane (ILM) peeling for macular edema associated with macular vein occlusion (MVO).

METHODS

In this retrospective, interventional, comparative case series study, 41 patients (41 eyes) underwent PPV either with or without ILM peeling for macular edema due to MVO. Twenty-eight eyes without ILM peeling (PPV alone) were compared with 13 eyes with ILM peeling (ILM-off). The main outcome measures were best-corrected visual acuity (BCVA) and foveal thickness, evaluated by optical coherence tomography.

RESULTS

Baseline demographic characteristics of the two groups were similar. Postoperative follow-up period ranged from 12 to 53 months (mean, 27.9 months). The postoperative mean BCVA improved and foveal thickness decreased significantly in both groups. The difference in BCVA between the two groups was not significant at any time point. The mean foveal thickness in the ILM-off group was thicker than that in the PPV alone group during the follow-up period. No patient had severe intraoperative or postoperative complications.

CONCLUSION

PPV either with or without ILM peeling may improve the anatomical and functional outcomes of macular edema secondary to MVO. Removal of the ILM does not appear to affect visual outcome; however, it may not reduce the foveal thickness as much as PPV alone.

摘要

目的

评估伴有或不伴有内界膜(ILM)剥除的玻璃体切除术(PPV)治疗黄斑静脉阻塞(MVO)相关黄斑水肿的效果。

方法

在这项回顾性、干预性、对比性病例系列研究中,41 名(41 只眼)患者因 MVO 导致黄斑水肿而接受了 PPV 治疗,其中 28 只眼未行 ILM 剥除(单纯 PPV),13 只眼行 ILM 剥除(ILM 去除)。主要观察指标是最佳矫正视力(BCVA)和光学相干断层扫描评估的黄斑中心凹厚度。

结果

两组患者的基线人口统计学特征相似。两组的术后随访时间为 12 至 53 个月(平均 27.9 个月)。两组术后 BCVA 均明显提高,黄斑中心凹厚度均明显降低。两组间任何时间点的 BCVA 差异均无统计学意义。在随访期间,ILM 去除组的黄斑中心凹平均厚度比单纯 PPV 组厚。无患者发生严重术中或术后并发症。

结论

伴有或不伴有 ILM 剥除的 PPV 可能改善 MVO 引起的黄斑水肿的解剖和功能结果。去除 ILM 似乎不会影响视力结果,但可能不如单纯 PPV 那样能使黄斑中心凹厚度减少那么多。

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