Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Japan.
Am J Ophthalmol. 2011 Jan;151(1):118-127.e1. doi: 10.1016/j.ajo.2010.07.007.
To use spectral-domain optical coherence tomography (SD OCT) to evaluate macular hole surgery outcomes and features predicting anatomic failure.
Retrospective, interventional case series.
Fifty-two eyes of 50 consecutive patients with macular holes were examined. All eyes underwent 3-port pars plana vitrectomy with internal limiting membrane peeling. Eyes were examined after surgery by dense serial SD OCT scanning over the macula.
Eyes with initial anatomic failure were significantly more likely to have greater axial length and refractive error and more posterior staphyloma compared with eyes with initial anatomic success (P = .031 to .0060, < .0001). Overall initial and final anatomic success rates were 92.3% (48 of 52 eyes). In highly myopic eyes with axial lengths of 26.0 mm or more, initial and final success rates were 73.3% (11 of 15 eyes) compared with 100.0% (37 of 37 eyes) of eyes with axial lengths of less than 26.0 mm (P = .0050). In highly myopic eyes, initial and final success rates were 0% (0 of 3 eyes) of eyes with axial lengths of 30.0 mm or more compared with 91.7% (11 of 12 eyes) of eyes with axial lengths of 26.0 mm or more and of less than 30.0 mm (P < .0001). Retinoschisis-like thickening of the outer retina was seen in 3 (75.0%) of 4 eyes with initial failure compared with 3 (6.3%) of 48 eyes with initial success (P = .0030).
Axial length of 30.0 mm or more may increase the risk of anatomic failure of macular hole surgery.
使用谱域光相干断层扫描（SD OCT）评估黄斑裂孔手术结果和预测解剖失败的特征。
回顾性、干预性病例系列。
对 50 例 52 只黄斑裂孔连续患者的眼睛进行了检查。所有眼均行 3 端口标准经睫状体平坦部玻璃体切除术联合内界膜剥除术。术后通过对黄斑进行密集的 SD OCT 序列扫描对眼进行检查。
与初始解剖成功的眼相比，初始解剖失败的眼更有可能具有更大的眼轴长度和屈光不正，以及更靠后的葡萄肿（P =.031 至.0060，<.0001）。总体初始和最终解剖成功率为 92.3%（52 眼中的 48 只）。在眼轴长度为 26.0 毫米或更长的高度近视眼中，初始和最终成功率分别为 73.3%（15 只眼中的 11 只）和 100.0%（37 只眼中的 37 只），而眼轴长度小于 26.0 毫米的眼为 100.0%（P =.0050）。在高度近视眼中，眼轴长度为 30.0 毫米或更长的眼初始和最终成功率为 0%（3 只眼中的 0 只），而眼轴长度为 26.0 毫米或更长且小于 30.0 毫米的眼初始和最终成功率为 91.7%（12 只眼中的 11 只）（P <.0001）。与初始成功的 48 只眼中的 3 只（6.3%）相比，初始失败的 4 只眼中有 3 只（75.0%）可见外视网膜类似视网膜劈裂的增厚（P =.0030）。
30.0 毫米或更长的眼轴可能会增加黄斑裂孔手术解剖失败的风险。
