Dr.Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical sciences, Ansari Nagar, New Delhi, 110029, India.
Graefes Arch Clin Exp Ophthalmol. 2011 Jul;249(7):987-95. doi: 10.1007/s00417-010-1609-1. Epub 2011 Jan 14.
To compare anatomical and functional outcomes using brilliant blue G (BBG) vs triamcinolone acetonide (TA)-assisted ILM peeling in macular hole surgery (MHS).
Simple, comparative, retrospective, non-randomised, interventional single-centre study.
Ninety-four eyes of 94 patients with idiopathic macular holes (≥ stage 2) who underwent MHS at our centre were included. Patients with failed macular holes, post-traumatic macular holes, history of previous vitreoretinal surgery, high myopia (6 dioptres or more) or any other macular pathology potentially limiting visual acuity, such as diabetic retinopathy or age-related macular degeneration, were excluded. An OCT evaluation of hole status was followed by pars plana vitrectomy for each of these eyes. Those who underwent TA-assisted ILM peeling were considered as group 1 and those with BBG-assisted ILM peeling were considered as group 2. Primary outcome measures included anatomical hole closure and functional success in terms of change in visual acuity of ≥2 LogMAR lines. Various preoperative factors were also evaluated.
Anatomical hole closure was achieved in 85 eyes (90.43%) and visual gain in 78 eyes (82.9%). Mean postoperative follow-up duration was 16.14 ± 1.95 months. No significant difference was found in anatomical and functional success between the two groups. Group 1 had a significantly higher incidence of postoperative glaucoma. Duration of symptoms of <12 months (p = 0.004) and preoperative visual acuity ≤1.0 LogMAR were related to anatomical success. However, greater visual gain was found in patients with chronic holes (≥12 months) (p = 0.046) and poor preoperative visual acuity (>1.0 LogMAR) (p = 0.001).
BBG-assisted ILM peeling offers an effective alternative to triamcinolone, with the added advantage of marked enhancement of vitreoretinal interface contrast with comparable hole closure rates and visual outcomes.
比较使用亮蓝 G（BBG）与曲安奈德（TA）辅助内界膜剥除治疗黄斑裂孔手术（MHS）的解剖和功能结果。
简单、比较、回顾性、非随机、干预性单中心研究。
纳入 94 例在我院接受 MHS 的特发性黄斑裂孔（≥2 期）患者的 94 只眼。排除黄斑裂孔失败、外伤性黄斑裂孔、既往玻璃体视网膜手术史、高度近视（6 屈光度或以上）或任何其他可能限制视力的黄斑病变，如糖尿病视网膜病变或年龄相关性黄斑变性。对这些患者的裂孔情况进行 OCT 评估，然后对每只眼进行经睫状体平坦部玻璃体切除术。接受 TA 辅助内界膜剥除的患者视为组 1，接受 BBG 辅助内界膜剥除的患者视为组 2。主要观察指标包括解剖裂孔闭合和视力提高≥2 LogMAR 线的功能成功率。还评估了各种术前因素。
85 只眼（90.43%）实现了解剖裂孔闭合，78 只眼（82.9%）视力提高。平均术后随访时间为 16.14±1.95 个月。两组在解剖和功能成功率方面无显著差异。组 1术后青光眼的发生率明显较高。症状持续时间<12 个月（p=0.004）和术前视力≤1.0 LogMAR 与解剖成功率相关。然而，慢性裂孔（≥12 个月）患者的视力提高幅度更大（p=0.046），术前视力较差（>1.0 LogMAR）（p=0.001）。
BBG 辅助内界膜剥除为曲安奈德提供了一种有效的替代方法，具有增强玻璃体视网膜界面对比度的显著优势，其裂孔闭合率和视力结果相当。
